True, but much of what's been said here is accurate.
FM is a low prestige field, that's absolutely true. We don't cure someone's cancer, get them through a severe illness in the ICU, cure their appendicitis, and so on. Getting someone's blood pressure, diabetes, or thyroid under control isn't sexy. Same with preventative care. All are very worthwhile but not exciting.
They pay isn't very high compared to other specialties, but you have to put it into context. I'm on track to make around 350k this year working 36 hours per week (8-5 with 90 minutes for lunch 4 days a week and 8-12 one day a week). No weekends, no nights, no holidays. I've taken 3 weeks of vacation so far with another 2 planned later this year. I take home phone call once every 2.5 months, I haven't set foot in the hospital professionally since residency. No codes, no having to tell family their loved ones have died, no having to tell someone they're dying. Only 3 years of residency was a big plus for me. Basically its a low stress job with banker's hours and a short residency that still has the potential to pay quite well. Oh, and hands down the best job market in the country. Its not even close.
Lots of students like the idea of being a subspecialist. I'm sure it is a nice feeling to be the doctor that other doctors send patients to when they're outside their comfort zone.
Academic medicine loves nothing more than crapping on other specialties and its really easy to do for FM (and EM) as we're both generalist fields so there's always a specialist that knows more about an area than we do. Interestingly, outside of academics the specialists appreciate us (or at least pretend to, which is good enough for me) since a) we send them business and b) handle everything outside of their area that they don't want to. The last part bothers students/residents. It doesn't bother most of us in practice because a) who wants ortho managing DM/HTN on patients and b) I can paid to manage those problems.
I think this deserves some context for OP - 300k is in fact reasonable from other FM docs I've spoken with on Reddit as well in many practice settings. I believe its worth making the comparison to a surgical specialty (lets just set aside ortho and NSG) - most
non-academic surgical specialties, including general, will start at a floor of 350, probably make 500 when they're at capacity, maybe 650 for uro/ENT which is the high end, but to make those numbers you are
NOT working 36 hours per week. You're working at minimum sixty, your weekend call is likely 1:4-1:6, and you take emergency call at least once a week, and you take all of your primary patient phone calls (which can be numerous) all week, at all hours. You may be doing this at multiple hospitals. Forever.
You essentially get double the paycheck for double the work. Academic surgeons can start around 250-275 and cap at 375 as well for another point of reference and still work at least 50 hour weeks.
So the compensation, which is a really important piece of the story, is not bad at all in FM. Its quite reasonable, and I believe students are very misinformed on the logistics of what is required to make 500k+. Your RVU production in that realm of existence is that you are a true workaholic and live to operate. You spend far, far more time in the hospital than you do in your own personal life. You do it because you love it and it makes you happy.
As always, the caveat is that there are exceptions. Anyone can find *a* surgeon who works 30 hours a week and makes 600k in the middle of no where with no real call in a critical access hospital because it isn't busy and everything gets transferred. But I believe I've described the averages and the more realistic lifestyle of most 'competitive' 'prestigious' lifestyles.
You work your ass off to make more than 500k in any RVU based specialty. There's no way around it. Students simply don't know how that works (most residents don't either), and that is where a lot of the misconceptions come from. There's this silly, absolutely untrue belief that if you can get through a prestigious hard residency that you make a ton of money and your life becomes cushy. That's fake news and not how it works. What actually happens is that people who have been gunning their entire lives go into prestigious difficult things, have to work harder than they've ever worked in their entire lives for another 5-7 years of residency, and by the time they're done they no longer know how to not work hard. Its just a way of life at that point - and so they make a ton of money, and they genuinely enjoy it. And by work hard I simply mean volume of work and hours put in.
