Large Student Debt and Salary

[DrBonesNStuff]

Everyone gets weirded out talking about income but it's a necessary conversation nowadays when student debt is at an all time high (at least for me). I'll have 400k debt accumulated at the end of residency. I don't plan on doing Pain fellowships but I also have no desire to live in areas of high COL (CA, NY, etc) I can do rural for awhile especially in the beginning while paying back my loans and my first job will likely offer me lower salary but I can maybe off-shoot it a bit by looking at underserved areas initially. Has anyone glossed over the 2017 AAPMR Compensation Survey? The executive summary is free and you can easily find it online

It got a 9% response rate which is pretty great (it's sample size is about 4x as large as the medscape survey). It divided up PM&R in its appropriate categories: General (280k), Peds (250k), Msk (286k), Pain (370k) etc.
Medscape 2018 Compensation report showed 269k. But everywhere on this forum I pretty much see doom and gloom unless you're Pain/interventional.

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[PMR2008]

Live like a resident for the first 5 years after training and you will be fine. Worst case scenario working in inpatient/subacute/outpatient rehab you will make 200k+ without fellowship and if you are not living in a big city. After taxes that would be about 150k. After expenses you should have 100k saved a year.
Don't buy a house, Rolex, BMW the first 5 years. Literally live like a resident and I don't see how you could not pay off the loans.

 

[Admiralk83]

Everyone gets weirded out talking about income but it's a necessary conversation nowadays when student debt is at an all time high (at least for me). I'll have 400k debt accumulated at the end of residency. I don't plan on doing Pain fellowships but I also have no desire to live in areas of high COL (CA, NY, etc) I can do rural for awhile especially in the beginning while paying back my loans and my first job will likely offer me lower salary but I can maybe off-shoot it a bit by looking at underserved areas initially. Has anyone glossed over the 2017 AAPMR Compensation Survey? The executive summary is free and you can easily find it online

It got a 9% response rate which is pretty great (it's sample size is about 4x as large as the medscape survey). It divided up PM&R in its appropriate categories: General (280k), Peds (250k), Msk (286k), Pain (370k) etc.
Medscape 2018 Compensation report showed 269k. But everywhere on this forum I pretty much see doom and gloom unless you're Pain/interventional.

Where do you want to work? When do you finish residency? If you want pm me and i can give some advice.

 

[cowboydoc]

Everyone gets weirded out talking about income but it's a necessary conversation nowadays when student debt is at an all time high (at least for me). I'll have 400k debt accumulated at the end of residency. I don't plan on doing Pain fellowships but I also have no desire to live in areas of high COL (CA, NY, etc) I can do rural for awhile especially in the beginning while paying back my loans and my first job will likely offer me lower salary but I can maybe off-shoot it a bit by looking at underserved areas initially. Has anyone glossed over the 2017 AAPMR Compensation Survey? The executive summary is free and you can easily find it online

It got a 9% response rate which is pretty great (it's sample size is about 4x as large as the medscape survey). It divided up PM&R in its appropriate categories: General (280k), Peds (250k), Msk (286k), Pain (370k) etc.
Medscape 2018 Compensation report showed 269k. But everywhere on this forum I pretty much see doom and gloom unless you're Pain/interventional.

The doom and gloom is coming from the Northeast (and negative people). If you're flexible on location, you can live relatively modestly and make far more than the averages above. Geographical arbitrage is huge! You already identified this. Once you own that debt, you'll be in good shape. You are already paying attention and planning ahead, so you're well ahead of the game.

 

[cbest]

Read everything that the White Coat Investor publishes too!

 

[DOctorJay]

White coat investor, physician on fire and Cory Fawcett are your best friends you haven’t met yet. Google, read, slay that debt.


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[cowboydoc]

White coat investor, physician on fire and Cory Fawcett are your best friends you haven’t met yet. Google, read, slay that debt.


Sent from my iPhone using SDN mobile

And Mr money moustache I'd you're REALLY serious about slaying your debt. WCI and POF are much more realistic.

 

[Dr. Ice]

Don’t move to NY NJ CA..bottom line. You’ll be fine if you make the right geogrphic choice.

 

[j4pac]

Don’t move to NY NJ CA..bottom line. You’ll be fine if you make the right geogrphic choice.

Or Chicago and Seattle. NJ has parts that aren’t bad...but close to NYC? Fogetaboutit.

 

[RangerBob]

Don’t move to NY NJ CA..bottom line. You’ll be fine if you make the right geogrphic choice.

Easier said than done sometimes. We had plans to live in a low COL area and payoff loans quickly, but then our son was born. Both my and my wife's families live in CA. We decided grandparents, aunts/uncles, and lots and lots of cousins being around regularly far outweighed the high taxes/COL. (You'd think with the taxes here we'd at least have decent roads...)

It really is quite nice here (fortunately it's not LA or SF). The weather is perfect, and it's about 15 minutes to the beach from where I live (though I actually prefer mountains/rivers). After almost a decade in the Midwest, the hills out here turning golden (pretty!) and then brown (ugly...) later in summer is taking some getting used to. I miss all the green and those Midwest thunderstorms...

Still, for the OP- I actually haven't seen/heard any doom and gloom. I think the future is great for PM&R. My wife and I have more debt than you, and it will probably a long time before she goes back to work (if she ever does). While it's depressing thinking about how little take-home I'll have as a percentage of my total salary, I'm still confident we'll do just fine.

 

[Dr. Ice]

Or Chicago and Seattle. NJ has parts that aren’t bad...but close to NYC? Fogetaboutit.

Well I can speak for the garden state:

- my wife went to a middle tier law school and can’t find a job that isn’t personal injury
- we both paid off a combined 250k in student loans as well as a car payment
- we live in a 2 bedroom apartment and pay rent probably equal to a mortgage for a brand new 6 bedroom house in the southeast or Midwest
- we live like college students. My furniture is 9 years old and has survived 4 moves, some of it is from ikea. We still eat at chain restaurants even though that’s a major faus pas by many who live here. Probably have a decent amount in savings but still not enough to buy a new construction house (to avoid the house fixes) without paying a million plus and 24-34k in property taxes if you count closing costs and the cost of purchasing furniture..don’t think mine will last a 5th move.
- if I don’t take off any time the rest of the year, only took 4 days so far to attend 2 separate cme courses(except weekends that are now spent studying for the glorious moc recert exam) I might be on track to make 320k..maybe..after almost 10 years of clinical experience
- we expect nothing and realize that not every day is guaranteed.

But...if you don’t wanna live like this...don’t live here..lol

 

[SSdoc33]

Well I can speak for the garden state:

- my wife went to a middle tier law school and can’t find a job that isn’t personal injury
- we both paid off a combined 250k in student loans as well as a car payment
- we live in a 2 bedroom apartment and pay rent probably equal to a mortgage for a brand new 6 bedroom house in the southeast or Midwest
- we live like college students. My furniture is 9 years old and has survived 4 moves, some of it is from ikea. We still eat at chain restaurants even though that’s a major faus pas by many who live here. Probably have a decent amount in savings but still not enough to buy a new construction house (to avoid the house fixes) without paying a million plus and 24-34k in property taxes if you count closing costs and the cost of purchasing furniture..don’t think mine will last a 5th move.
- if I don’t take off any time the rest of the year, only took 4 days so far to attend 2 separate cme courses(except weekends that are now spent studying for the glorious moc recert exam) I might be on track to make 320k..maybe..after almost 10 years of clinical experience
- we expect nothing and realize that not every day is guaranteed.

But...if you don’t wanna live like this...don’t live here..lol

grass is always greener?

lets be honest, there is a reason you dont want to move to BFE.

and you also didnt mention any costs associated with any children -- if there are any.

you will certainly make more money if you practice in nebraska or north dakota. but, you may not be surrounded by like-minded people. the schools may be poor. there are a million reasons why less desirable areas are cheaper -- precisely because they are less desirable....

 

[Dr. Ice]

grass is always greener?

lets be honest, there is a reason you dont want to move to BFE.

and you also didnt mention any costs associated with any children -- if there are any.

you will certainly make more money if you practice in nebraska or north dakota. but, you make not be surrounded by like-minded people. the schools may be poor. there are a million reasons why less desirable areas are cheaper -- precisely because they are less desirable....

Yes kids in the picture. Why does it have to be Nebraska or North Dakota..just sharing Jersey is def not the best option depending on how you wanna live. I know for a fact major us cities outside of nj/ny have a lower cost of living. Are you really gonna argue that?

 

[SSdoc33]

Yes kids in the picture. Why does it have to be Nebraska or North Dakota..just sharing Jersey is def not the best option depending on how you wanna live. I know for a fact major us cities outside of nj/ny have a lower cost of living. Are you really gonna argue that?

of course not. i completely understand. california and the northeast are not the places to practice if you want to make a buttload of money in medicine.

but, there are certainly other perks. dont discount the 20-30k/year/kid that private schools would cost if you moved to rural virginia, or delaware, or oklahoma.

i have a lot of friends who chased the dream of big money in the middle of nowhere. 2 are miserable, 1 moved back east, and the other is divorced. yes, you will make more money. that may not translate into happiness.

i got offered double my first starting offer to work at a practice on the great lakes. turned it down easily without even thinking twice.

 

[j4pac]

The point about childcare is a good one. But living in a place with a high COL doesn’t necessarily mean decent public schools. The good schools are often in suburbs away from expensive metropolitan areas. I remember drawing a budget for all of the places I interviewed for residency and came to the conclusion that I’d be putting my family in a predicament by moving to NY, NJ, or Chicago. There’s no way I could have afforded private schooling with the already astronomical COL. I ended up either cancelling interviews or ranking those programs significantly lower.

 

[Dr. Ice]

The point about childcare is a good one. But living in a place with a high COL doesn’t necessarily mean decent public schools. The good schools are often in suburbs away from expensive metropolitan areas. I remember drawing a budget for all of the places I interviewed for residency and came to the conclusion that I’d be putting my family in a predicament by moving to NY, NJ, or Chicago. There’s no way I could have afforded private schooling with the already astronomical COL. I ended up either cancelling interviews or ranking those programs significantly lower.

The public school debate always makes me a little nutty. I went to a completely unranked high school in NJ. My parents, immigrants, were trying to make ends meet and there was no looking online to see which school had which ranking or score out of 10. The education I received was decent, probably could have been bettter but I felt well prepared for pre med curriculum. I made lasting friendships which I still have to this day. Would a similar unranked school in a non northeast state give me the same experience, I suppose the argument is that it wouldn’t but I don’t know. Obviously the kid has to be self motivated and that probably plays a more important role than the school but I suppose you could debate that. There are plenty of stories of kids who went to highly ranked public high school or private school then Ivy League and wound up in a profession that doesn’t pay or can’t find work. There are probably a ton of stories to the contrary also.

 

[SSdoc33]

The public school debate always makes me a little nutty. I went to a completely unranked high school in NJ. My parents, immigrants, were trying to make ends meet and there was no looking online to see which school had which ranking or score out of 10. The education I received was decent, probably could have been bettter but I felt well prepared for pre med curriculum. I made lasting friendships which I still have to this day. Would a similar unranked school in a non northeast state give me the same experience, I suppose the argument is that it wouldn’t but I don’t know. Obviously the kid has to be self motivated and that probably plays a more important role than the school but I suppose you could debate that. There are plenty of stories of kids who went to highly ranked public high school or private school then Ivy League and wound up in a profession that doesn’t pay or can’t find work. There are probably a ton of stories to the contrary also.

i think the goal is give your child the best chances at success. yes, you can succeed without great schooling, but theres a better chance of success with better schools.

 

[j4pac]

The public school debate always makes me a little nutty. I went to a completely unranked high school in NJ. My parents, immigrants, were trying to make ends meet and there was no looking online to see which school had which ranking or score out of 10. The education I received was decent, probably could have been bettter but I felt well prepared for pre med curriculum. I made lasting friendships which I still have to this day. Would a similar unranked school in a non northeast state give me the same experience, I suppose the argument is that it wouldn’t but I don’t know. Obviously the kid has to be self motivated and that probably plays a more important role than the school but I suppose you could debate that. There are plenty of stories of kids who went to highly ranked public high school or private school then Ivy League and wound up in a profession that doesn’t pay or can’t find work. There are probably a ton of stories to the contrary also.

I agree. The first private school I attended was medical school. I attended about 10 schools through grade school...and there were really good ones and really bad ones. The bad ones were dangerous and I honestly feared for my life at times. It was a distraction to say the least. But I made it...largely because I was going to make it regardless of the hell hole I was surrounded by.

But I don’t want to assume that my children will be as well adapted. That type of environment can break kids. And honestly, life 20 years ago isn’t as bad as it is today. Kids are pretty f’d up these days. And I don’t think that society telling them that they’re not f’d up is helping things.

My kids are going to go to A rated schools that are SAFE and with the lowest possible probability of encountering one of the gun-slinging psychopaths and psychobabble BS that prevalent in today’s schools. If I can’t find that through a public school...they’re going to a private school. I’ll live in an area where the COL isn’t so high that I am not void of options. The stakes are too high. I foresee the gap between the have and have nots increasing and I do feel sorry for the kids...but this really is what our society deserves for being weak.