If you could go back in time, would you still choose psychiatry? If still psych, would you have done anything different about your career?

[allantois]

Neurology seems like the worst field of medicine to me.. funny enough that it deals with the same organ and I do not hate neuroscience or neuroanatomy at all

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[Anotherwin]

Fields like rads and gas would have allowed me to enjoy the idea of a longer career without the threat of midlevels and having to push myself. Rads is immune and gas has crnas but unlikely to be impacted in the next 10 years.

I was the last doc hired at one of my jobs and only mid levels come and go for 6 years now. Admin simply says why on earth would we hire anyone but np's as they can bill the same and cost half the amount.

The jobs will be there but you will see a shift in salaries to 175-200k ish for employed positions by 2030 and essentially be forced to supervise multiple nps but likely they r all autonomous by then. Future is fine for getting a job but inflation adjusted expect 200k ish as upper limit going forward.

That sounds like a rather grim future. What advice do you have so I can still be successful in the future?

 

[luckybuck]

The jobs will be there but you will see a shift in salaries to 175-200k ish for employed positions by 2030

What would cause this to happen? Its funny how some of the highest earning people on here have the worst predictions for the future. I wonder why that is

 

[ksharp33]

Fields like rads and gas would have allowed me to enjoy the idea of a longer career without the threat of midlevels and having to push myself. Rads is immune and gas has crnas but unlikely to be impacted in the next 10 years.

I was the last doc hired at one of my jobs and only mid levels come and go for 6 years now. Admin simply says why on earth would we hire anyone but np's as they can bill the same and cost half the amount.

The jobs will be there but you will see a shift in salaries to 175-200k ish for employed positions by 2030 and essentially be forced to supervise multiple nps but likely they r all autonomous by then. Future is fine for getting a job but inflation adjusted expect 200k ish as upper limit going forward.

I agree with this post and I had the same two fields in mind (gas and rads) and wish I had done either one of those instead. It would likely allow me to achieve FIRE way earlier. Both gas and rads have far higher earning potential and seemingly better opportunities overall even in desirable areas. The need for imaging and anesthesia will only increase with time. Compare the salary ranges of both gas and rads with the average psychiatrist and you'll see that the 90th percentile for psychiatrists is usually the 10th percentile for gas or rads. Generally when one makes partner in a private practice gas or rads group, their income and vacation time go up substantially (12+ weeks of vacation is fairly common). Take a look at the job board for anesthesia or for radiology and compare it to the job board for psychiatry. Although psychiatry may have a lot of jobs, most of them are quite undesirable on paper and there is a reason many remain unfilled for years.

Psychiatry has many cons to it as highlighted above.

• There is definitely the threat of midlevels and it seems like almost every nurse I meet is training to become psych NP on the side. I have colleagues who are forced to supervise midlevels at their jobs. I see wild medication regimens from NPs in the community all the time. Most patients cannot tell the difference between a psych NP and a psychiatrist and will often mistakenly refer to their NP as their "psychiatrist."
• Poor compensation relative to training - salaries are increasing a bit but many jobs still low-balling and paying in 200s for full-time equivalent. Average psychiatrist makes similar to what a hospitalist makes despite doing an extra year of training.
• Stigma and low prestige - although diminishing to some degree, it is still present and it is also one of the few fields that has entire groups dedicated to being against it (see anti psychiatry movement, Scientology to name a few).
• The work itself can be emotionally draining and it appears to be harder to put in high number of hours (if one were so inclined) in psychiatry compared to gas or rads.
• Occupational hazard - psychiatry residents are the most likely to be assaulted compared to trainees of other specialties. I have also seen some studies that show EM being at higher risk with psychiatry following in second place. I know multiple attending or residents that have been attacked at some point in their career.

Psych does have the benefit of having a low threshold for starting your own private practice, which may be its saving grace.

 

[forchinet121]

I agree with this post and I had the same two fields in mind (gas and rads) and wish I had done either one of those instead. It would likely allow me to achieve FIRE way earlier. Both gas and rads have far higher earning potential and seemingly better opportunities overall even in desirable areas. The need for imaging and anesthesia will only increase with time. Compare the salary ranges of both gas and rads with the average psychiatrist and you'll see that the 90th percentile for psychiatrists is usually the 10th percentile for gas or rads. Generally when one makes partner in a private practice gas or rads group, their income and vacation time go up substantially (12+ weeks of vacation is fairly common). Take a look at the job board for anesthesia or for radiology and compare it to the job board for psychiatry. Although psychiatry may have a lot of jobs, most of them are quite undesirable on paper and there is a reason many remain unfilled for years.

Psychiatry has many cons to it as highlighted above.

• There is definitely the threat of midlevels and it seems like almost every nurse I meet is training to become psych NP on the side. I have colleagues who are forced to supervise midlevels at their jobs. I see wild medication regimens from NPs in the community all the time. Most patients cannot tell the difference between a psych NP and a psychiatrist and will often mistakenly refer to their NP as their "psychiatrist."
• Poor compensation relative to training - salaries are increasing a bit but many jobs still low-balling and paying in 200s for full-time equivalent. Average psychiatrist makes similar to what a hospitalist makes despite doing an extra year of training.
• Stigma and low prestige - although diminishing to some degree, it is still present and it is also one of the few fields that has entire groups dedicated to being against it (see anti psychiatry movement, Scientology to name a few).
• The work itself can be emotionally draining and it appears to be harder to put in high number of hours (if one were so inclined) in psychiatry compared to gas or rads.
• Occupational hazard - psychiatry residents are the most likely to be assaulted compared to trainees of other specialties. I have also seen some studies that show EM being at higher risk with psychiatry following in second place. I know multiple attending or residents that have been attacked at some point in their career.

Psych does have the benefit of having a low threshold for starting your own private practice, which may be its saving grace.

This is all correct

 

[SmallBird]

Fields like rads and gas would have allowed me to enjoy the idea of a longer career without the threat of midlevels and having to push myself. Rads is immune and gas has crnas but unlikely to be impacted in the next 10 years.

I was the last doc hired at one of my jobs and only mid levels come and go for 6 years now. Admin simply says why on earth would we hire anyone but np's as they can bill the same and cost half the amount.

The jobs will be there but you will see a shift in salaries to 175-200k ish for employed positions by 2030 and essentially be forced to supervise multiple nps but likely they r all autonomous by then. Future is fine for getting a job but inflation adjusted expect 200k ish as upper limit going forward.

In 2012 a very prolific poster made exactly the same prediction for the same reasons but the data just doesn't support what you are saying. A core premise of the argument that midlevel replacement will be absolute and inevitable is a monolithic imagining of hospital administrators as being uncaring individuals who cannot embrace any degree of nuance and don't care about patients. In reality they are a diverse group of good and bad individuals who have to navigate a large number of competing interests but the vast majority of systems continue to conclude that physicians represent an important part of their care delivery model. There are jobs for psychiatrists open in every single state and they pay significantly more than a few years ago. We just hired two new psychiatrists at our system for salaries that would have been unimaginable for new grads just five years ago and represent anticipated multi-year investments by our system.

 

[SmallBird]

I agree with this post and I had the same two fields in mind (gas and rads) and wish I had done either one of those instead. It would likely allow me to achieve FIRE way earlier. Both gas and rads have far higher earning potential and seemingly better opportunities overall even in desirable areas. The need for imaging and anesthesia will only increase with time. Compare the salary ranges of both gas and rads with the average psychiatrist and you'll see that the 90th percentile for psychiatrists is usually the 10th percentile for gas or rads. Generally when one makes partner in a private practice gas or rads group, their income and vacation time go up substantially (12+ weeks of vacation is fairly common). Take a look at the job board for anesthesia or for radiology and compare it to the job board for psychiatry. Although psychiatry may have a lot of jobs, most of them are quite undesirable on paper and there is a reason many remain unfilled for years.

Psychiatry has many cons to it as highlighted above.

• There is definitely the threat of midlevels and it seems like almost every nurse I meet is training to become psych NP on the side. I have colleagues who are forced to supervise midlevels at their jobs. I see wild medication regimens from NPs in the community all the time. Most patients cannot tell the difference between a psych NP and a psychiatrist and will often mistakenly refer to their NP as their "psychiatrist."
• Poor compensation relative to training - salaries are increasing a bit but many jobs still low-balling and paying in 200s for full-time equivalent. Average psychiatrist makes similar to what a hospitalist makes despite doing an extra year of training.
• Stigma and low prestige - although diminishing to some degree, it is still present and it is also one of the few fields that has entire groups dedicated to being against it (see anti psychiatry movement, Scientology to name a few).
• The work itself can be emotionally draining and it appears to be harder to put in high number of hours (if one were so inclined) in psychiatry compared to gas or rads.
• Occupational hazard - psychiatry residents are the most likely to be assaulted compared to trainees of other specialties. I have also seen some studies that show EM being at higher risk with psychiatry following in second place. I know multiple attending or residents that have been attacked at some point in their career.

Psych does have the benefit of having a low threshold for starting your own private practice, which may be its saving grace.

I followed your links and there were 2000 postings for psychiatry jobs. What are you trying to say? In what location can you not find a job?

 

[ksharp33]

That person never said they couldn’t find a job, just that many of them are undesirable, presumably in comparison to the anesthesia and rads jobs he posted.

Exactly.

 

[psyspy]

Fields like rads and gas would have allowed me to enjoy the idea of a longer career without the threat of midlevels and having to push myself. Rads is immune and gas has crnas but unlikely to be impacted in the next 10 years.

I was the last doc hired at one of my jobs and only mid levels come and go for 6 years now. Admin simply says why on earth would we hire anyone but np's as they can bill the same and cost half the amount.

The jobs will be there but you will see a shift in salaries to 175-200k ish for employed positions by 2030 and essentially be forced to supervise multiple nps but likely they r all autonomous by then. Future is fine for getting a job but inflation adjusted expect 200k ish as upper limit going forward.

Thoughts on the more niche options then? Corrections? Having your own practice? Juggling multiple jobs? Honestly from what I'm hearing, most traditional employed salaries are starting to hit a ceiling, so I really think in the future it'll be some kind of two-tier system of niche practices vs employed positions.

I'm also getting a gut feeling I should be prioritizing prestige in my rank list a bit more than I wanted to

I'm just gonna keep telling myself "ceiling is high in psych if I work and network hard enough"

 

[finalpsychyear]

Thoughts on the more niche options then? Corrections? Having your own practice? Juggling multiple jobs? Honestly from what I'm hearing, most traditional employed salaries are starting to hit a ceiling, so I really think in the future it'll be some kind of two-tier system of niche practices vs employed positions.

I'm also getting a gut feeling I should be prioritizing prestige in my rank list a bit more than I wanted to

I'm just gonna keep telling myself "ceiling is high in psych if I work and network hard enough"

Corrections is great if your wiling to take risk. Multiple jobs always a great idea. Being able to get into admin roles i.e. director, cmo etc at those jobs is another advantage.

 

[finalpsychyear]

In 2012 a very prolific poster made exactly the same prediction for the same reasons but the data just doesn't support what you are saying. A core premise of the argument that midlevel replacement will be absolute and inevitable is a monolithic imagining of hospital administrators as being uncaring individuals who cannot embrace any degree of nuance and don't care about patients. In reality they are a diverse group of good and bad individuals who have to navigate a large number of competing interests but the vast majority of systems continue to conclude that physicians represent an important part of their care delivery model. There are jobs for psychiatrists open in every single state and they pay significantly more than a few years ago. We just hired two new psychiatrists at our system for salaries that would have been unimaginable for new grads just five years ago and represent anticipated multi-year investments by our system.

Yes, I'd rather not say the name but the poster was named after a prn anxiolytic. I am hoping to be wrong. I'd rather prepare for the worst and use it as added motivation for the time being pushing through mid 50's clinical hours weekly. Not as bad with pd admin hours thrown into that.

 

[clausewitz2]

Yes, I'd rather not say the name but the poster was named after a prn anxiolytic. I am hoping to be wrong. I'd rather prepare for the worst and use it as added motivation for the time being pushing through mid 50's clinical hours weekly. Not as bad with pd admin hours thrown into that.

He is basically Internet psychiatry Bloody Mary, isn't he?

If you say his name three times into the mirror with the lights off, he will write five posts about why the salary you are being paid at your job is economically impossible and no one has ever been paid that much for that work anywhere ever.

 

[TheRightMedication]

Back when I lurked and did not post, I found the provocations of that poster sometimes interesting, and the measured response to it offered some good role modeling.

 

[forchinet121]

#bringbackvistaril

 

[Merovinge]

I agree with this post and I had the same two fields in mind (gas and rads) and wish I had done either one of those instead. It would likely allow me to achieve FIRE way earlier. Both gas and rads have far higher earning potential and seemingly better opportunities overall even in desirable areas. The need for imaging and anesthesia will only increase with time. Compare the salary ranges of both gas and rads with the average psychiatrist and you'll see that the 90th percentile for psychiatrists is usually the 10th percentile for gas or rads. Generally when one makes partner in a private practice gas or rads group, their income and vacation time go up substantially (12+ weeks of vacation is fairly common). Take a look at the job board for anesthesia or for radiology and compare it to the job board for psychiatry. Although psychiatry may have a lot of jobs, most of them are quite undesirable on paper and there is a reason many remain unfilled for years.

Psychiatry has many cons to it as highlighted above.

• There is definitely the threat of midlevels and it seems like almost every nurse I meet is training to become psych NP on the side. I have colleagues who are forced to supervise midlevels at their jobs. I see wild medication regimens from NPs in the community all the time. Most patients cannot tell the difference between a psych NP and a psychiatrist and will often mistakenly refer to their NP as their "psychiatrist."
• Poor compensation relative to training - salaries are increasing a bit but many jobs still low-balling and paying in 200s for full-time equivalent. Average psychiatrist makes similar to what a hospitalist makes despite doing an extra year of training.
• Stigma and low prestige - although diminishing to some degree, it is still present and it is also one of the few fields that has entire groups dedicated to being against it (see anti psychiatry movement, Scientology to name a few).
• The work itself can be emotionally draining and it appears to be harder to put in high number of hours (if one were so inclined) in psychiatry compared to gas or rads.
• Occupational hazard - psychiatry residents are the most likely to be assaulted compared to trainees of other specialties. I have also seen some studies that show EM being at higher risk with psychiatry following in second place. I know multiple attending or residents that have been attacked at some point in their career.

Psych does have the benefit of having a low threshold for starting your own private practice, which may be its saving grace.

I am certainly not going to disagree with the financials you discuss, I have 2 good friends in gas and some less close friends in rads and they are all doing well financially. However the jobs in gas where you are supervising a number of CRNAs and responsible for several OR rooms at time sound like an abject nightmare to me and this is pretty common for the high salary positions. There are also several places that have completely phased out gas MDs for CRNAs, if anything I see more midlevel creep in gas than psych. Gas is also a field where excrement can really hit the ventilation system and the venn diagram of the type of person who feels comfortable being responsible for a person living/dying based on their split second decision making and the person practicing psychiatry is going to have minimal overlap.

For rads, the PP make BIZANK but holy God does the job sound like misery to me. They have to go through so many scans so quickly to make the large sums of money. Squirreled away in a bunker for 8-12 hours at time. It definitely takes a certain type of person to do this work and again I think the crossover with psych is low.

Even if you only care about money, having a job you can do and feel relatively happy with for 25-30 years is going to more financially beneficial than a job that burns you out after 10 (particularly due to the way taxes work).

 

[finalpsychyear]

I am certainly not going to disagree with the financials you discuss, I have 2 good friends in gas and some less close friends in rads and they are all doing well financially. However the jobs in gas where you are supervising a number of CRNAs and responsible for several OR rooms at time sound like an abject nightmare to me and this is pretty common for the high salary positions. There are also several places that have completely phased out gas MDs for CRNAs, if anything I see more midlevel creep in gas than psych. Gas is also a field where excrement can really hit the ventilation system and the venn diagram of the type of person who feels comfortable being responsible for a person living/dying based on their split second decision making and the person practicing psychiatry is going to have minimal overlap.

For rads, the PP make BIZANK but holy God does the job sound like misery to me. They have to go through so many scans so quickly to make the large sums of money. Squirreled away in a bunker for 8-12 hours at time. It definitely takes a certain type of person to do this work and again I think the crossover with psych is low.

Even if you only care about money, having a job you can do and feel relatively happy with for 25-30 years is going to more financially beneficial than a job that burns you out after 10 (particularly due to the way taxes work).

Rads and anes are great but it also comes with more risk and liability. Wknd and holiday call and probably for most some nights as well.
You could argue that a 500k doc in rads and anes is probably working significantly more vs a close to 400k doc in psych who may also never work wknds, nights, or holidays ever. That extra 100k is closer to 60k post tax for a lot more work for what i am seeing.

 

[ksharp33]

I am certainly not going to disagree with the financials you discuss, I have 2 good friends in gas and some less close friends in rads and they are all doing well financially. However the jobs in gas where you are supervising a number of CRNAs and responsible for several OR rooms at time sound like an abject nightmare to me and this is pretty common for the high salary positions. There are also several places that have completely phased out gas MDs for CRNAs, if anything I see more midlevel creep in gas than psych. Gas is also a field where excrement can really hit the ventilation system and the venn diagram of the type of person who feels comfortable being responsible for a person living/dying based on their split second decision making and the person practicing psychiatry is going to have minimal overlap.

For rads, the PP make BIZANK but holy God does the job sound like misery to me. They have to go through so many scans so quickly to make the large sums of money. Squirreled away in a bunker for 8-12 hours at time. It definitely takes a certain type of person to do this work and again I think the crossover with psych is low.

Even if you only care about money, having a job you can do and feel relatively happy with for 25-30 years is going to more financially beneficial than a job that burns you out after 10 (particularly due to the way taxes work).

Rads and anes are great but it also comes with more risk and liability. Wknd and holiday call and probably for most some nights as well.
You could argue that a 500k doc in rads and anes is probably working significantly more vs a close to 400k doc in psych who may also never work wknds, nights, or holidays ever. That extra 100k is closer to 60k post tax for a lot more work for what i am seeing.

All valid points.

 

[psyspy]

All valid points.

500k in those specialties is median. Close to 400k in psych is over 75%itle. I highly doubt that the psych guy is "never working weekends, nights, etc"

edit: you know, now that I clicked that anesthesia jobs link, those high salaries really drop off a ton when you set sights on desirable metros. Of course, this is the case for psych too, but not nearly to the extent of the discrepancy seen in anesthesia. Most of the desirable metros posting anything above 400k also call for cardiac anesthesia specifically.

For further perspective, some rural-ish georgia postings 1-2h away from atlanta are $425k-$500k

and at least with psych, the ceiling is theoretically far higher than just below 300k

Someone tell me I'm wrong.

 

[finalpsychyear]

500k in those specialties is median. Close to 400k in psych is over 75%itle. I highly doubt that the psych guy is "never working weekends, nights, etc"

edit: you know, now that I clicked that anesthesia jobs link, those high salaries really drop off a ton when you set sights on desirable metros. Of course, this is the case for psych too, but not nearly to the extent of the discrepancy seen in anesthesia. Most of the desirable metros posting anything above 400k also call for cardiac anesthesia specifically.

For further perspective, some rural-ish georgia postings 1-2h away from atlanta are $425k-$500k

and at least with psych, the ceiling is theoretically far higher than just below 300k

Someone tell me I'm wrong.

for midwest based on 2021 data median is :
rads 560
anes 473
psych 303

 

[psyspy]

for midwest based on 2021 data median is :
rads 560
anes 473
psych 303

Variance for rads and gas is quite high though. Those figures drop off more proportionally like I was saying in desirable metros. For non-academic psych, you'll still get 250K+ in employed positions in high profile metros, so the dropoff is proportionally lower. It is important to note though that 50% of people must make higher and 50% must make lower.

Also important that these distributions are all skewed to the right. There are way more psychs pulling 500k+ than pulling less than 100-150k

 

[ksharp33]

500k in those specialties is median. Close to 400k in psych is over 75%itle. I highly doubt that the psych guy is "never working weekends, nights, etc"

This is true as well. I was about to edit my post and add that but you beat me to it.

It's also hard to hit those same high salaries from one job in psychiatry, most psychiatrists are having to juggle multiple jobs or gigs whereas you can hit those numbers from one job in anesthesia or rads.

 

[clausewitz2]

For rads, the PP make BIZANK but holy God does the job sound like misery to me. They have to go through so many scans so quickly to make the large sums of money. Squirreled away in a bunker for 8-12 hours at time. It definitely takes a certain type of person to do this work and again I think the crossover with psych is low.

One of my therapy patients is a radiologist who does some expert witness work on the side. The standard of care is to never miss any significant imaging finding, ever. He kind of hates his life. N = 1.

 

[shoomer]

One of my therapy patients is a radiologist who does some expert witness work on the side. The standard of care is to never miss any significant imaging finding, ever. He kind of hates his life. N = 1.

The fact that Rads has permanent, objective evidence of anything being missed sounds like an anxiety-provoking nightmare.

 

[finalpsychyear]

This is true as well. I was about to edit my post and add that but you beat me to it.

It's also hard to hit those same high salaries from one job in psychiatry, most psychiatrists are having to juggle multiple jobs or gigs whereas you can hit those numbers from one job in anesthesia or rads.

This is true. I'm not sure most are going to toggle multiple gigs in psych so obviously quite a bit of pay difference for the average person. Not sure what the value of this is but on my 3 days remote a week I always get to workout for a solid hour and pick up any groceries to make sure I eat healthy all before 5pm as i can literally do it during my day. Rads and Anes always have the wonderful junk that stocks most physician lounges that I don't have to be tempted by.

 

[Username2015]

I agree with this post and I had the same two fields in mind (gas and rads) and wish I had done either one of those instead. It would likely allow me to achieve FIRE way earlier. Both gas and rads have far higher earning potential and seemingly better opportunities overall even in desirable areas. The need for imaging and anesthesia will only increase with time. Compare the salary ranges of both gas and rads with the average psychiatrist and you'll see that the 90th percentile for psychiatrists is usually the 10th percentile for gas or rads. Generally when one makes partner in a private practice gas or rads group, their income and vacation time go up substantially (12+ weeks of vacation is fairly common). Take a look at the job board for anesthesia or for radiology and compare it to the job board for psychiatry. Although psychiatry may have a lot of jobs, most of them are quite undesirable on paper and there is a reason many remain unfilled for years.

Psychiatry has many cons to it as highlighted above.

• There is definitely the threat of midlevels and it seems like almost every nurse I meet is training to become psych NP on the side. I have colleagues who are forced to supervise midlevels at their jobs. I see wild medication regimens from NPs in the community all the time. Most patients cannot tell the difference between a psych NP and a psychiatrist and will often mistakenly refer to their NP as their "psychiatrist."
• Poor compensation relative to training - salaries are increasing a bit but many jobs still low-balling and paying in 200s for full-time equivalent. Average psychiatrist makes similar to what a hospitalist makes despite doing an extra year of training.
• Stigma and low prestige - although diminishing to some degree, it is still present and it is also one of the few fields that has entire groups dedicated to being against it (see anti psychiatry movement, Scientology to name a few).
• The work itself can be emotionally draining and it appears to be harder to put in high number of hours (if one were so inclined) in psychiatry compared to gas or rads.
• Occupational hazard - psychiatry residents are the most likely to be assaulted compared to trainees of other specialties. I have also seen some studies that show EM being at higher risk with psychiatry following in second place. I know multiple attending or residents that have been attacked at some point in their career.

Psych does have the benefit of having a low threshold for starting your own private practice, which may be its saving grace.

While having a low threshold for private practice is great because it takes power away from large corporate employers, it also means that NPs can start private practices easier in psychiatry relative to other fields. This is why we are seeing so many NP only private practices opening up (at least in my state).

Psychiatry is relatively good now, but I am a pessimist and expect things to be worse in the future due to the excess quantity of NPs graduating each year.

 

[Shikima]

My extended family, and eventually my own kids, I don't recommend medicine at all.
I'm going to be recommending my kids pursue a trade - electrical, plumbing, etc - and then open their own business.
Tree cutting, landscaping, hardscaping, custom sawmill, anything, but with element that they have their own business after 1-2 years of employment.

Medicine has gone to scat and will only get worse. The bureacratic entropy at play is as heavy as the tide.

Seeing as how you are already in too deep, make the best of it. Psychiatry is a little better than many of the other options.

If the factors at play were aligned right, I would walk away today and not look back.

I'm personally working on my Plan B to be a niche farmer/rancher/apiarist.

+1. Glad you know medicine, you'll know when you're getting substandard care.

Go become an airline pilot. You'll make just as much and work way less. With the pilot shortages too, I am willing to bet that any of the airline companies would pay off your student loans debt for a lengthy contract.

 

[untapped]

I switched out of anesthesia to psych, so I may be able to provide some insight. I would definitely do it again, as it was the right fit for me. I think psych is a much better lifestyle specialty in terms of stress and flexibility for most people. These specialties are just entirely different in the work environment and stressors. Give me a difficult psych patient all day every day over a crap your pants operating room crisis. I think I could have maybe done pain fellowship but those patients are so draining. My anesthesia buddy seems happy and makes probably double what I do, so I guess I can't speak for everyone. I can't say I've ever woken up and said man if only I made 500k instead of 300k I would truly be happy with life.

 

[clausewitz2]

+1. Glad you know medicine, you'll know when you're getting substandard care.

Go become an airline pilot. You'll make just as much and work way less. With the pilot shortages too, I am willing to bet that any of the airline companies would pay off your student loans debt for a lengthy contract.

Unless of course you only manage to land a job with a regional airline where you are lucky to break 100k.

The airline pilot shortage is kind of nonsense. The airlines basically stopped hiring pilots for a couple years and since it takes them a while to train these pilots after hire, this is catching up with them.

 

[Marasmus1]

500k in those specialties is median. Close to 400k in psych is over 75%itle. I highly doubt that the psych guy is "never working weekends, nights, etc"

edit: you know, now that I clicked that anesthesia jobs link, those high salaries really drop off a ton when you set sights on desirable metros. Of course, this is the case for psych too, but not nearly to the extent of the discrepancy seen in anesthesia. Most of the desirable metros posting anything above 400k also call for cardiac anesthesia specifically.

For further perspective, some rural-ish georgia postings 1-2h away from atlanta are $425k-$500k

and at least with psych, the ceiling is theoretically far higher than just below 300k

Someone tell me I'm wrong.

I don` like hearsay but I know two psychiatrists who work as medical directors and pull somewhere around 800k annually with 40 hours of work. Their tax returns are accessible by public. Now this is very rare in psychiatry but seems doable.

 

[B52slinger]

I don` like hearsay but I know two psychiatrists who work as medical directors and pull somewhere around 800k annually with 40 hours of work. Their tax returns are accessible by public. Now this is very rare in psychiatry but seems doable.

3 attendings in my program (out of 10 in a small community program) make >800k/year doing purely employed work (no PP). This is a bottom-ranked program that struggles to fill each class. Makes it seem more common than I previously thought. They work around 60 hours a week working multiple jobs

 

[OldPsychDoc]

Skip the PhD and get started at least 5 years earlier.

 

[DOswag]

#bringbackvistaril

I remember vistaril lol! Have they been banished from SDN for forever or still lurking around here?

 

[liquidshadow22]

3 attendings in my program (out of 10 in a small community program) make >800k/year doing purely employed work (no PP). This is a bottom-ranked program that struggles to fill each class. Makes it seem more common than I previously thought. They work around 60 hours a week working multiple jobs

Not sure how that is even possible. Is this CA?

 

[finalpsychyear]

I remember vistaril lol! Have they been banished from SDN for forever or still lurking around here?

please don't' say the name a third time...

 

[psychmd03]

Not sure how that is even possible. Is this CA?

The money or not filling spots? The money for sure is quite possible

 

[the5thelement]

A resident who was a year below me worked for a few hospitals before settling for private practice and is currently living in a paid off $1.2 million house making $800k/year. A second resident worked in hawaii for several years making $300k/year and then returning to mainland working for corrections /private practice managing $700k/year (for last 3 years) - he has 3 paid off houses and very little stress at this point. I could never stare at xrays or images all day so rads is out and anestheliogy aint all that - the gas makes them have bizzarre personalities.Forget surgery if you want have a normal family life. Psychiatry is far superior (despite the drawbacks mentioned above). The ability to hang your own shingle as a physician (with low overhead) trumps everything else.

 

[Iamnew2]

A resident who was a year below me worked for a few hospitals before settling for private practice and is currently living in a paid off $1.2 million house making $800k/year. A second resident worked in hawaii for several years making $300k/year and then returning to mainland working for corrections /private practice managing $700k/year (for last 3 years) - he has 3 paid off houses and very little stress at this point. I could never stare at xrays or images all day so rads is out and anestheliogy aint all that - the gas makes them have bizzarre personalities.Forget surgery if you want have a normal family life. Psychiatry is far superior (despite the drawbacks mentioned above). The ability to hang your own shingle as a physician (with low overhead) trumps everything else.

how do they make 700-800k/year?

 

[docksan]

Yes, I would. No I wouldn't do things different just yet. Always learning every day.

 

[OldPsychDoc]

please don't' say the name a third time...

 

[psyspy]

how do they make 700-800k/year?

They know a guy who knows a guy

 

[psychmd03]

how do they make 700-800k/year?

Doesnt even take a stretch to figure out many ways that would be attainable. Corrections pays well already Many jobs will easily get you into the upper 300s or more. A medical director job and some other patient care would easily net you another 300+. You could have a combo of inpatient and OP. IP in the am OP in the afternoon/evening. Couple extra IP shifts here and there and again easily hitting those numbers. More ways- have a few NP/PAs that work under you and cover NH. You take 30-40% of what they collect. Take the NH director or other stipend many give. And then have an OP or IP job as your main gig and you will again be living a high-earning life. Pysch has so many ways to earn a very high income if one wants to and they are efficient and set up the right systems. Psych is also great for being able to work under 40hrs while earning a better-than-average wage so one can invest that time elsewhere. The biggest issue I have with psych is unless you really set up a solid business and hire others you will always be trading your time for money.

 

[docksan]

Expected Candleja

 

[B52slinger]

how do they make 700-800k/year?

Not very difficult in my area where attendings are spending <1 hour per day total on seeing their 10+ patient census for "full-time" jobs that pay 300k+. This is including admissions....

I don't want to come off as xenophobic but I'm at a bottom ranked community program (we SOAP every year) that has mostly IMG attendings who seem to have no qualms with spending 2-3 minutes per patient and leaving as quickly as possible for their next job(s), which would likely be considered egregious at the fairly well-ranked medical school I studied at. Most of our resident learning was self-directed as a result (uptodate, textbooks, videos, etc). I've told many medical students not to come here but the reality is that a lot of psychiatrists are not practicing even remotely close to the standard of care I observed in med school.

 

[dl2dp2]

Not very difficult in my area where attendings are spending <1 hour per day total on seeing their 10+ patient census for "full-time" jobs that pay 300k+. This is including admissions....

I don't want to come off as xenophobic but I'm at a bottom ranked community program (we SOAP every year) that has mostly IMG attendings who seem to have no qualms with spending 2-3 minutes per patient and leaving as quickly as possible for their next job(s), which would likely be considered egregious at the fairly well-ranked medical school I studied at. Most of our resident learning was self-directed as a result (uptodate, textbooks, videos, etc). I've told many medical students not to come here but the reality is that a lot of psychiatrists are not practicing even remotely close to the standard of care I observed in med school.

lol is this really what it takes to make 700k as a "bottom-ranked" "IMG attending"? Oy vey...

 

[psyspy]

Not very difficult in my area where attendings are spending <1 hour per day total on seeing their 10+ patient census for "full-time" jobs that pay 300k+. This is including admissions....

I don't want to come off as xenophobic but I'm at a bottom ranked community program (we SOAP every year) that has mostly IMG attendings who seem to have no qualms with spending 2-3 minutes per patient and leaving as quickly as possible for their next job(s), which would likely be considered egregious at the fairly well-ranked medical school I studied at. Most of our resident learning was self-directed as a result (uptodate, textbooks, videos, etc). I've told many medical students not to come here but the reality is that a lot of psychiatrists are not practicing even remotely close to the standard of care I observed in med school.

Hmm on the flipside, from what I've heard, even in some academic residencies, learning is mostly self-directed by seeing a lot of patients. Isn't this ideal in a specialty where patient care is heavily influenced by seeing firsthand impressions? Even from my limited sample of didactics lectures, I would've rather indeed self-learned those in particular

 

[psyspy]

Neurology seems like the worst field of medicine to me.. funny enough that it deals with the same organ and I do not hate neuroscience or neuroanatomy at all

The problem is you have to undergo so much detailed training and use so little of it, compared to any other specialty

Edit: quite honestly the impression I got from my neuro rotation is that it's like taking math courses up to calculus 3 just to be able to do introductory college physics.

 

[docksan]

I do a lot of neurology. (Maybe more than neurology lulz)

 

[allantois]

Headache might as well be a psych issue.. throwing random meds to see what sticks lol

 

[Sporadicus]

I can't imagine doing any other medical specialty than psychiatry. I'd rather not be a doctor than be a surgeon or an internist. I could live with neurology if psych wasn't a possibility. The only thing I would do differently is to start a private practice immediately upon finishing residency.

 

[jbomba]

Ditto. I would do something else outside of medicine if I wasnt a psychiatrist. Theres just so much suck in the majority of other fields.