How to not care about money for specialty selection?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

Idahomie

Full Member
2+ Year Member
Joined
Sep 17, 2019
Messages
219
Reaction score
916
Hi everyone!

Genuine question here. I've always considered myself a planner. Now that I finally have been accepted (Hallelujah), I've been looking more towards the future. I am really concerned that I am falling into the mindset of caring way too much about what specialties earn more than others. I catch myself peeping at MGMA data way more than I should.

I have never wanted to go into medicine for the money. However, I have two kids, and I want to give them a great life with ample opportunities. This is obviously easier to accomplish with greater income flow. My biggest concern is that I've already started ruling out certain specialties purely based on a financial standpoint, without any experience in those fields.

Does anyone have any tips on how to avoid this? I really don't want to be "that guy" in my med school class...

Members don't see this ad.
 
Money has always been the baseline for nearly all careers.

That said, you have to consider not only salary, but how happy you'll be doing the job. What good is all that salary if you're miserable?
 
  • Like
Reactions: 12 users
One more thing.

Since we're in the age of COVID. it's likely that you have yet to set foot on a med school campus.

Thus., focus on doing well in med school, because a weak Step 2 score may eliminate those nice lucrative specialties right off the bat and you'll be stuck with the less paying ones, like it or not.
 
  • Like
Reactions: 7 users
Members don't see this ad :)
I have never wanted to go into medicine for the money. However, I have two kids, and I want to give them a great life with ample opportunities. This is obviously easier to accomplish with greater income flow.
Does anyone have any tips on how to avoid this? I really don't want to be "that guy" in my med school class...
I don't think you should feel bad about worrying about finances. Most individuals who attend medical school come from wealthy backgrounds and haven't ever had to live paycheck to paycheck. I had always heavily considered pediatrics in urban, underserved settings but I'm not sure I feel comfortable doing so when I'll be graduating from medical school with 350k+ in loans and interest of roughly 10k per year. PSLF is unreliable, NHSC is competitive, and I have no family finances to fall back on.

I'm still waiting on financial aid awards but I feel like I'd only be comfortable pursuing a low-paying specialty if I can graduate with 200k in debt or less. Any higher and I feel like my post-graduate life would be dominated by debt.
 
  • Care
Reactions: 1 user
One more thing.

Since we're in the age of COVID. it's likely that you have yet to set foot on a med school campus.

Thus., focus on doing well in med school, because a weak Step 2 score may eliminate those nice lucrative specialties right off the bat and you'll be stuck with the less paying ones, like it or not.

That's another thing I'm worried about. I've heard from a lot of people that the best way to succeed in matching in the more competitive specialties is to start early. Talk to advisors in M1, get into research, meet the home program faculty, etc... With pass/fail preclinical years and p/f Step 1, a student could take all of these extra steps to be competitive, only to suck on Step 2. By that point, it is so late in the game that matching into any specialty becomes an absolute scramble.

Thanks for the advice about focusing on succeeding in school first. Now I just need to figure out how to occupy my time and effort on something else besides matching and specialty choice. I assume there isn't much I can do right now to prep for years 1 and 2. I really need more hobbies :(
 
I like to remember that even the lowest paid doctors make a lot more than the average American.
 
  • Like
  • Love
Reactions: 9 users
If you find a specialty you truly love, consider the lifetime earnings compared to the alternative.

A lot of docs try to retire in their mid-40s for a number of reasons -- but a significant portion chose a specialty for a reason other than passion for it... others love their specialty and want to continue practicing as long as they can -- it is their passion.

Find your passion/s, I wouldnt be surprised if the lower paying specialty comes out closer than you think (if not ahead) in the longterm.
 
Last edited:
  • Like
Reactions: 3 users
Congrats on your A. Next four years will help you choose.

In addition to all that has been said here, remember there is physician burnout.

Also, re: making SDN a hobby, some have tried and later got suspended!!!
 
  • Haha
  • Like
Reactions: 6 users
Even if you end up in the lowest paying specialty and >350k in debt you will be fine as long as you are diligent to live within your means after residency for 3-5 years. If you can pay off all your debt in that time great but even if you pay a significant portion off then you will be fine. Even the poorest specialty is a top 5% earner in America.
 
  • Like
Reactions: 1 users
Keep in mind that kids need adults who love them and who spend time with them as much or more than they need the economic resources a parent can provide. Find that sweet spot between high wages and work/life balance.
 
  • Like
  • Love
Reactions: 22 users
Members don't see this ad :)
Keep in mind that kids need adults who love them and who spend time with them as much or more than they need the economic resources a parent can provide. Find that sweet spot between high wages and work/life balance.
At least one parent should give full attention to the kids.
 
  • Like
Reactions: 1 user
Just realized from another thread that @KnightDoc is no longer banned. Welcome back KD! :cool::cool::cool::cool::cool::cool::cool::cool::cool::cool::cool::cool::cool::cool:
Thank you!!! I will try my very best to behave going forward!!! I missed you guys!!! :cool:
 
  • Like
  • Care
  • Love
Reactions: 10 users
There is nothing wrong with taking into consideration your future earning potential when deciding between specialties. Money should never be the main deciding factor, but also should not be treated as some taboo subject in medicine. Yes, we go into medicine to help others, but the reality is that we come out with considerable debt, years of lost income (and compounding interest!), a need to plan for retirement, and a responsibility to our families. Life as an attending can be rough, and gratitude, while nice, does not pay the bills (especially gratitude from hospital administrators: :clown:).

As LizzyM said, find a balance between money, joy in medicine, and quality of life. MGMA reports are a good place to start, but also look at the average number of hours worked per specialty. Yes surgeons make more money per hour, but the reason why their salaries are significantly higher is also because they work more hours too. Also recognize that there are significant variations in pay (and work) within any given specialty, in addition to opportunities to supplement one's income through 1099 contract work. As an example, in IM, starting pay in my area ranged from $130k (lol) up to $350k, and maybe even higher if one were willing to go rural, work more nights/shifts, and/or go locum$. Given how important choosing one's specialty is, students should shadow broadly and look at any available data so they can make an informed decision on how to best maximize their own happiness (a function of career satisfaction, work life balance, and money / being free from debt). Just my thoughts
 
Last edited:
  • Like
  • Love
Reactions: 7 users
Hi everyone!

Genuine question here. I've always considered myself a planner. Now that I finally have been accepted (Hallelujah), I've been looking more towards the future. I am really concerned that I am falling into the mindset of caring way too much about what specialties earn more than others. I catch myself peeping at MGMA data way more than I should.

I have never wanted to go into medicine for the money. However, I have two kids, and I want to give them a great life with ample opportunities. This is obviously easier to accomplish with greater income flow. My biggest concern is that I've already started ruling out certain specialties purely based on a financial standpoint, without any experience in those fields.

Does anyone have any tips on how to avoid this? I really don't want to be "that guy" in my med school class...
Do what you like to do... Do not follow money, money is important but secondary to happiness..I personally know my med school colleagues that went into surgery with intention of making more money because of their high Step 1 scores were absolutely miserable after a year only to drop it and try for something else. Just remember that you will be doing the specialty for the rest of your life....
 
  • Like
Reactions: 1 users
Does anyone have any tips on how to avoid this? I really don't want to be "that guy" in my med school class...
If you keep an open mind your specialty will probably find you. You'll go onto a service and realize that you're doing work you enjoy with a patient population that speaks to you. And you'll like your attendings.

You can make a lot of money in any specialty if that's your priority.
 
  • Like
Reactions: 3 users
Did you have a ban expiration timer or something?
Yup! It was never a "ban," as one of the mods explained in another thread where people were asking. That's just how some people here were describing it. It was a "post hold," which did indeed have a timer.
 
  • Like
Reactions: 1 user
Thank you everyone for all the advice! It's absolutely given me a lot to think about. You are all far wiser than I when it comes to this sort of thing. From now on I will start trying to channel that motivation I have to be a good provider for my family into smaller steps. I guess the first step for now is to rock year 1.

Also thanks for the surprise appearance @KnightDoc :cool:
 
  • Like
  • Love
Reactions: 1 users
Thank you everyone for all the advice! It's absolutely given me a lot to think about. You are all far wiser than I when it comes to this sort of thing. From now on I will start trying to channel that motivation I have to be a good provider for my family into smaller steps. I guess the first step for now is to rock year 1.

Also thanks for the surprise appearance @KnightDoc :cool:
My pleasure! I honestly did not mean to crash, but, as you can see, I was summoned! :)

Also, notice I refrained from giving advice since I am at least a year behind you, and honestly have no idea how to weigh monetary concerns. I have always wanted to be a pediatrician, and it's my dad who has been urging me to keep an open mind as I am exposed to different things.

My plan is to try different things (assuming I get there) and to then see what floats my boat. My understanding is also that while almost everyone starts out thinking they are going to have their choice of competitive specialty, the actual works tends to get in the way, and a lot of people planning on one thing end up matching into another, at which point a choice is made for them.

I'm just going to work as hard as I can, and do as well as I can, so that I will hopefully have the greatest possible range of options available to me. I am also not going to worry about this until after I get there and see how competitive I might be for various specialties. Again, certain choices might very well end up being made for me well before I actually have to choose myself. Plus, I have the comfort of knowing that pediatrics will probably always be there for me, which is what drove me here in the first place.

Best of luck to you!!! I am pretty sure you will find it will all work out well in the end.
 
Last edited:
My pleasure! I honestly did not mean to crash, but, as you can see, I was summoned! :)

Also, notice I refrained from giving advice since I am at least a year behind you, and honestly have no idea how to weigh monetary concerns. I have always wanted to be a pediatrician, and it's my dad who has been urging me to keep an open mind as I am exposed to different things.

My plan is to try different things (assuming I get there) and to then see what floats my boat. My understanding is also that while almost everyone starts out thinking they are going to have their choice of competitive specialty, the actual works tends to get in the way, and a lot of people planning on one thing end up matching into another, at which point a choice is made for them.

I'm just going to work as hard as I can, and do as well as I can, so that I will hopefully have the greatest possible range of options available to me. I am also not going to worry about this until after I get there and see how competitive I might be for various specialties. Again, certain choices might very well end up being made for me well before I actually have to choose myself. Plus, I have the comfort of knowing that pediatrics will probably always be there for me, which is what drove me here in the first place.

Best of luck to you!!! I am pretty sure you will find it will all work out well in the end.

You should become a pediatrician then. Even pediatricians can pay off their loans and live a very comfortable life
 
You should become a pediatrician then. Even pediatricians can pay off their loans and live a very comfortable life
Could you please explain what you mean by "even pediatricians"? I never knew it was a low-paying job. Is it?
 
You should become a pediatrician then. Even pediatricians can pay off their loans and live a very comfortable life
That's currently the plan! I'm just going to try to keep an open mind, and see where the journey takes me.
 
  • Like
Reactions: 1 user
Could you please explain what you mean by "even pediatricians"? I never knew it was a low-paying job. Is it?
Compared to the competitive specialties, family medicine, pediatrics and ob/gyn are considered "low paying." Everything is relative, and while pediatricians make way more than the average American worker, even in medicine, there are tiers, and neurosurgeons and cardiologists are not paid the same as pediatricians and family doctors.
 
  • Like
Reactions: 1 users
Compared to the competitive specialties, family medicine, pediatrics and ob/gyn are considered "low paying." Everything is relative, and while pediatricians make way more than the average American worker, even in medicine, there are tiers, and neurosurgeons and cardiologists are not paid the same as pediatricians and family doctors.
Yup got that. But was surprised when that post said it like peds barely make ends meet. Not sure if there is any physician who is paid less than 150-200k at the least - even for starters, no? (assuming they are practicing)
 
Yup got that. But was surprised when that post said it like peds barely make ends meet. Not sure if there is any physician who is paid less than 150-200k at the least - even for starters, no? (assuming they are practicing)
Depending on debt and location, $150k can certainly be barely making ends meet.

Imagine $500k debt in NYC.
 
  • Like
Reactions: 2 users
Depending on debt and location, $150k can certainly be barely making ends meet.

Imagine $500k debt in NYC.
This^^^^^. $150K is certainly nowhere near the poverty line, but depending on location, amount of debt to service, years of foregone income, amount paid for the education, etc., it doesn't feel like a lot to many, and is what leads many to gun for competitive specialties. NYU's free tuition for all was meant to address this, although it comes with no strings attached.

Also, I haven't done a nationwide survey of physician salaries, but I'd imagine there are locations and clinics that pay a lot less than $150K, and doctors who for whatever reason either want to do that work or find that it's the best job they can get, so I'm not so sure that a MD or DO is a road to Easy Street for everyone. Again, I honestly don't have the data to support this, but I'd find it hard to believe if there weren't enough FMGs and IMGs willing to work for less to drive salaries down for some people in some locations, just like in other areas of the economy, even with a nationwide physician shortage.
 
Last edited:
Could you please explain what you mean by "even pediatricians"? I never knew it was a low-paying job. Is it?

We are THE lowest paying specialty as a whole
 
  • Like
Reactions: 3 users
Depending on debt and location, $150k can certainly be barely making ends meet.

Imagine $500k debt in NYC.

This^^^^^. $150K is certainly nowhere near the poverty line, but depending on location, amount of debt to service, years of foregone income, amount paid for the education, etc., it doesn't feel like a lot to many, and is what leads many to gun for competitive specialties. NYU's free tuition for all was meant to address this, although it comes with no strings attached.

Also, I haven't done a nationwide survey of physician salaries, but I'd imagine there are locations and clinics that pay a lot less than $150K, and doctors who for whatever reason either want to do that work or find that it's the best job they can get, so I'm not so sure that a MD or DO is a road to Easy Street for everyone. Again, I honestly don't have the data to support this, but I'd find it hard to believe that there weren't enough FMGs and IMGs willing to work for less to drive salaries down for some people in some locations, just like in other areas of the economy, even with a nationwide physician shortage.
That post FYI did not mention location.
We are THE lowest paying specialty as a whole
Thank you for clarifying.
 
As you know, money isn't EVERYTHING to EVERYONE!!! :) Some people really do have a calling.
And there's nothing wrong with that. If we choose to take that up - we will be happy. If that's the only choice - we will make ourselves happy. Anyways will be a lot better than most other jobs
 
Hi everyone!

Genuine question here. I've always considered myself a planner. Now that I finally have been accepted (Hallelujah), I've been looking more towards the future. I am really concerned that I am falling into the mindset of caring way too much about what specialties earn more than others. I catch myself peeping at MGMA data way more than I should.

I have never wanted to go into medicine for the money. However, I have two kids, and I want to give them a great life with ample opportunities. This is obviously easier to accomplish with greater income flow. My biggest concern is that I've already started ruling out certain specialties purely based on a financial standpoint, without any experience in those fields.

Does anyone have any tips on how to avoid this? I really don't want to be "that guy" in my med school class...
Just do what you’re truly passionate about. Unlike most people in SDN, I’m willing to quit medical school, if I truly don’t resonate with the medical career. Yeah, I’ll have wasted few years with lots of loan, but I don’t want to do something that I don’t enjoy doing for the rest of my life.
 
  • Like
Reactions: 1 users
Someone once told me. In a career you can;

1. make a lot of money,
2. make a big difference,
3. have a good work life balance.

but you only get to pick 2.

its already been said but you gotta do what you are really passionate about.
 
There are much easier ways to make money. Instead of worrying about this why don't you focus on the latter so it doesn't become an issue down the line :)
 
Honestly, it's my primary hobby. Sure eats into my wargaming time (which used to be my primary hobby)!
Mine too, hoping to change after current cycle is over :)
 
Someone once told me. In a career you can;

1. make a lot of money,
2. make a big difference,
3. have a good work life balance.

but you only get to pick 2.

its already been said but you gotta do what you are really passionate about.

You could have all 3 with a specialty like Ophtho or something.
 
  • Like
Reactions: 4 users
There are much easier ways to make money. Instead of worrying about this why don't you focus on the latter so it doesn't become an issue down the line :)
Aren't you the person who sold their startup for 30 mllion or something? Lmao. I don't think everyone can just do that.
 
Ophtho
Derm
What other specialties?

Are these two super hard to get into?
I believe derm has fewer slots. Yes, I believe both are hard to get but let's see what attendings say. May be going to T10 helps?
 
Top