Medical Examiners

[SexPistol]

I checked the FAQ but didnt see much info on medical examiners...how much do they make, do you just do a path residency, what are the hours, what is a typical day like, do you enjoy work?

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[yaah]

They generally make less than most other pathologists, often because MEs work for counties or cities (i.e. the government) and thus have government paychecks.

All that is required is a path residency (either AP only or AP/CP) and a forensics fellowship, which is one year. Most medical examiners are exclusively medical examiners although there are some who practice general pathology and serve as the medical examiner (usually a rural location without many autopsies).

As for what the hours are and if the work is enjoyable, that is so variable as to be silly to try to answer. It would depend on many things. Duties and responsibilities also vary from state to state I believe. Figure on lots of weekend and night call, lots of trials, and the like. And don't pay attention to what TV says a medical examiner does.

 

[SexPistol]

thanks...i assume no job is as glamorous as it is on TV...are there a lot of interesting cases or are most just run of the mill... im sure the answer is "depends"

 

[CameronFrye]

I checked the FAQ but didnt see much info on medical examiners...how much do they make, do you just do a path residency, what are the hours, what is a typical day like, do you enjoy work?

As an aside, you also need to clarify what you mean by "medical examiner". The same term means very different things depending on which state you are in. In Virginia, local medical examiners just have to have a medical license and serve as a coordinator between the state office and the local authorities. In my locality, all of the local ME's are path residents, but that is certainly not the case in all of the state.

I assume you are specifically talking about forensic pathologists, who may have the title of medical examiner, coroner, etc., depending on the local system.

 

[yaah]

thanks...i assume no job is as glamorous as it is on TV...are there a lot of interesting cases or are most just run of the mill... im sure the answer is "depends"

The answer to almost everything is "it depends." A lot of Forensic path work is outside of the actual autopsy, whether it's collecting data, calling people, or going to court. You do lots of autopsies but often they are similar types of cases and you are documenting injuries. To some people, an autopsy on a gunshot victim is fascinating but to others it's tedium because you have to document so much stuff and pay attention to minutae.

Most of the "it depends" depends on your own perspective though. No one is going to be able to tell you what will fascinate you or appeal to you as a career choice. I can sit here until I am blue in the face telling people that prostate core biopsies are fascinating but a lot of people will just roll their eyes and say that they suck. And that's fine. I think breast path is a pain in the ass.

 

[mlw03]

thanks...i assume no job is as glamorous as it is on TV...are there a lot of interesting cases or are most just run of the mill... im sure the answer is "depends"

in addition to what yaah said, it also depends on where you are with respect to the type of cases you'll see. big cities will obviously have more homocide than rural places. the thing with all of path though is that while something may seem run of the mill, it may not be. pathologists have to consider the zebras on their differential - this applies whether you're looking under the microscope or doing an autopsy.

 

[FrnscnPharmGal]

I worked for an ME for a little over a year, mostly for my high school senior project. It was in a suburb of Denver, so not too large of a population. Colorado does not require Coroner's to be ME's, but the guy that I worked for did in fact have his MD. He didn't have to go out to scenes at 2am unless it was a big scene (esp. in terms of media coverage). He had a staff of pathologist assistants trained to represent him at crime scenes. They did rotating 12 hr shifts throughout the week.

I do know that the Denver Coroner's office was posting jobs earlier in the year for path assistants with just bachelors to start at $40-50,000 a year. One might assume that based on those #'s, an ME could make decent money considering their job and education levels are that much higher. While you could make even MORE money in a larger city, the demands are more extreme.

 

[LADoc00]

I just saw some ad somewhere for a forensic pathologist in the 185-200 range, which is shocking because I almost never see numbers that high. Usually it is more 120K with government structured increases in pay.

Basically if you plan on residing in any high cost of living areas like SF, LA, NYC, Miami, DC, Boston etc etc, prepare to have a low-moderate standard of living.

Your take home on 120 is roughly 6500/mo, figuring 1500 is probably going for loans, another 500 for a car, maybe 2K for a reasonable home rental(figure 3-4K if you are in SF or NYC), you live on 2K or less/mo. Not much "get ahead" room considering you would be around 33-35 years old year 1. At 40 years old you would be topping at about 140K-150K, not much more than a hard working sole prop. electrician business, and the electrician was earning income at 21 years old with no loans to payback.

Its almost impossible for a government entity to really be competitive with the sunk costs of medical school in the picture and the percieved risk of education (given you have multiple points where you can fail out/sink compared typically to an attorney who just has the bar exam and an MBA who essentially has no fund of knowledge testing).

 

[TheCritic]

I was talking to a forensic pathologist....scratch that....a person claiming to be a forensic pathologist in a seemingly well-to-do neighborhood and he claimed to make 15k a pop doing consultant work or something of the sort. Anyone care to comment as to whether or not this was total BS. I really haven't a clue, nor do I care, but I thought it might liven this thread up a bit.

 

[Mindy]

Hah! I am finally actually a medical examiner (okay, fellow, but whatever!) Let me tell you, it is as fabulous, exciting, and interesting as I hoped it would be. As I think everyone knows I am in Boston, which has been tough media-wise as of late.

Regardless, the cases are fantastic. The work is extremely interesting. I am enjoying what I do entirely.

My hours are rather long. I get to work by 8:30 and leave by 7:30 or so. But, I am just getting started so everything I do is cumbersome, from autopsies (the more trauma, the slower I am) to dictations, to reports. I expect I will get faster, but then I also expect my work load will increase. Presently I am doing 2 autopsies 3 days a week on average. I am sure I will be doing more than that in a short bit of time.

The cases here, since they are more or less statewide, are terrific. Even cases that should be rote and boring all seem to have "a twist."

Cash wise, LA is right. I will not make a mint. But to be able to go to work everyday and be able to enjoy what I do is worth it. His figures regarding housing are actually low for Boston. But, the salary here at least actually approaches $200,000 at the high end, which is enough to live comfortably enough in Boston. For me at least, it is just not all about cash.

Happy to answer questions!

Mindy

 

[Brian Pavlovitz]

Regardless, the cases are fantastic. The work is extremely interesting. I am enjoying what I do entirely.

The cases here, since they are more or less statewide, are terrific. Even cases that should be rote and boring all seem to have "a twist."

Cash wise, LA is right. I will not make a mint. But to be able to go to work everyday and be able to enjoy what I do is worth it.

For me at least, it is just not all about cash.

Mindy

Mindy--

What a refreshing post! Imagine: someone who actually is excited about the work they do without worrying about how much "bank" they will make.

Keep up the good work, and keep us informed.

 

[yaah]

Imagine: someone who actually is excited about the work they do without worrying about how much "bank" they will make.

Agreed.

 

[TheCritic]

Hah! I am finally actually a medical examiner (okay, fellow, but whatever!) Let me tell you, it is as fabulous, exciting, and interesting as I hoped it would be. As I think everyone knows I am in Boston, which has been tough media-wise as of late.

Regardless, the cases are fantastic. The work is extremely interesting. I am enjoying what I do entirely.

My hours are rather long. I get to work by 8:30 and leave by 7:30 or so. But, I am just getting started so everything I do is cumbersome, from autopsies (the more trauma, the slower I am) to dictations, to reports. I expect I will get faster, but then I also expect my work load will increase. Presently I am doing 2 autopsies 3 days a week on average. I am sure I will be doing more than that in a short bit of time.

The cases here, since they are more or less statewide, are terrific. Even cases that should be rote and boring all seem to have "a twist."

Cash wise, LA is right. I will not make a mint. But to be able to go to work everyday and be able to enjoy what I do is worth it. His figures regarding housing are actually low for Boston. But, the salary here at least actually approaches $200,000 at the high end, which is enough to live comfortably enough in Boston. For me at least, it is just not all about cash.

Happy to answer questions!

Mindy

Intriguing. Actually of all the subspecialties of path, Forensics really does interest me most. But I have always been afraid of the low income. After 5-6 years of residency plus fellowship and probably 300K of student loan debt, a family to support, I just don't know if just enjoying my job immensely will make up for the hundred thousand dollars or so less in income. It's really kind of unfortunate.

However, 200K actually would be enough for me to consider it. Even 180K would tempt me considerably. I wonder how common place those incomes are. 120K for someone with that much education just seems criminal to me. Of course, I know....it depends......

Of course the upside is that I could do AP/FP and cut a year off residency.

 

[djmd]

As I think everyone knows I am in Boston, which has been tough media-wise as of late.
The cases here, since they are more or less statewide, are terrific. Even cases that should be rote and boring all seem to have "a twist."

No kidding about the twists...
Did you figure out that Office Sullivan shot Officer Barrigan?

ha ha, I'm only kidding cause I'm jealous.. you get to be in Boston.

 

[CameronFrye]

Intriguing. Actually of all the subspecialties of path, Forensics really does interest me most. But I have always been afraid of the low income. After 5-6 years of residency plus fellowship and probably 300K of student loan debt, a family to support, I just don't know if just enjoying my job immensely will make up for the hundred thousand dollars or so less in income. It's really kind of unfortunate.

However, 200K actually would be enough for me to consider it. Even 180K would tempt me considerably. I wonder how common place those incomes are. 120K for someone with that much education just seems criminal to me. Of course, I know....it depends......

Of course the upside is that I could do AP/FP and cut a year off residency.

New ME in major midwestern city: starts at 130k, bumps to 150k as soon as he passes his boards. I don't know what he can max out at.

 

[Mindy]

Brian P. How have you been? Neat to hear you are in the 'Cuse after all!

DJMD: I happen to live in Southie, yah ditty rat.

For a good place to check out med examiner jobs, check out: www.thename.org and look in there jobs section. Salaries are climbing a bit, but there will constantly be a struggle by the government to keep them as low as possible. Salaries are increasing really only because so few pathologists are becoming FPs, though there seems to be a bump in interest lately. It just isn't a money maker of a job. But it is a really interesting job. I just don't find myself caring all that much about the cash.

Mindy

 

[LADoc00]

without sounding like a broken record, if they ever instituted a separate government funded training program for MEs where you didnt have to suck up 4 years in med school+5 more in residency/fellowship and 200K in educational bills, Forensics would attract a TON of very bright people and do a world of good for law enforcement.

 

[LADoc00]

Imagine: someone who actually is excited about the work they do without worrying about how much "bank" they will make.

Imagine: there is a subgroup of people out there with wonderous and magical things called "trust funds" who dont have to worry about making a 1500 buck student loan payment, 500 bucks in car payments and a 4000 buck mortgage each month in addition to feeding a family.

Imagine: You are a working class guy with a wife who doesnt work and takes care of the kids and you are solely responsible for the household income.

Lets not get all high and mighty Brian because there are actually middle class readers of this forum out there that are stressing about the current economic climate of healthcare.

 

[gungho]

good to hear from you. i remember reading your posts a year or two before i started residency and here you are in fellowship and i'm PGY-4! wow, time flies. i thought about forensics very seriously-did a short rotation at a ME's office. the work was very interesting, etc., but i just didn't think i could deal with all that human tragedy every day. guess i'm getting more, instead of less, sensitive in my old age.

 

[mlw03]

making a 1500 buck student loan payment, 500 bucks in car payments and a 4000 buck mortgage each month in addition to feeding a family.

loan repayment - not a choice

$500 car payment - choice. No one is going to force me to get rid of my perfectly functional Mazda when i graduate and pick up a Lexus with a much higher payment. Also, no one says I have to get a new car every 3 years instead of paying off a car and then having no payments for 5 years. These are choices.

$4000 mortgage - again, a choice. You can easily afford a beautiful home for half that in most places in this country - just not LA, San Fran, Boston, NYC, and maybe a few others. Living in these places is also a choice, and in exchange for living in a more "desireable" location you're going to pay for it.

You talk about middle-class members of this forum, but then you make it sound like someone making $160K per year would struggle to make ends meet. that's just absurd. standard of living is about choice, and the choices we make determine how much we have to work to attain what's important to us. for those in medicine who decide enjoying what they do is more important than bringing home enough money to have every material possession under the sun, i say good for them. and for people who want to work 75 hours per week and make $800K per year, good for them too. but we all should be respectful of each other's choices and accept them as they are.

 

[TheCritic]

I think the important point here is that forensics is definitely a field some people can fall in love with, not just enjoy, and this is worth a lot more than a dollar amount. However I think most of us would agree that 120K for someone with that amount of training is underpaid. I hope you would agree. If forensics were somehow its own program after undergrad then I think 120k is a lot more understandable, but it's not. However, it is about choices and there is definitely nothing to be ashamed of as a FP making that kind of money and loving your job that much.

It's a great field. Oh and there is one way to make bank as an FP. Just ask this lady (although I don't think she is actually a pathologist):

 

[djmd]

loan repayment - not a choice

$4000 mortgage - again, a choice. You can easily afford a beautiful home for half that in most places in this country - just not LA, San Fran, Boston, NYC, and maybe a few others. Living in these places is also a choice, and in exchange for living in a more "desireable" location you're going to pay for it.

You talk about middle-class members of this forum, but then you make it sound like someone making $160K per year would struggle to make ends meet.

He is talking about people from a middle class background.
And yes you don't have to buy a new fancy car, but saying your mortgage is easily half that for a beautiful house is pretty unrealistic...
But don't worry about having a 4000 mortgage payment with 160k, you will be lucky to qualify for a 200,000 house... So your mortgage will be closer to 2000.

 

[LADoc00]

loan repayment - not a choice

$500 car payment - choice. No one is going to force me to get rid of my perfectly functional Mazda when i graduate and pick up a Lexus with a much higher payment. Also, no one says I have to get a new car every 3 years instead of paying off a car and then having no payments for 5 years. These are choices.

$4000 mortgage - again, a choice. You can easily afford a beautiful home for half that in most places in this country - just not LA, San Fran, Boston, NYC, and maybe a few others. Living in these places is also a choice, and in exchange for living in a more "desireable" location you're going to pay for it.

You talk about middle-class members of this forum, but then you make it sound like someone making $160K per year would struggle to make ends meet. that's just absurd. standard of living is about choice, and the choices we make determine how much we have to work to attain what's important to us. for those in medicine who decide enjoying what they do is more important than bringing home enough money to have every material possession under the sun, i say good for them. and for people who want to work 75 hours per week and make $800K per year, good for them too. but we all should be respectful of each other's choices and accept them as they are.

LMAO....500 bucks a month is roughly the payments for 2 Honda Civics, one for you and a spouse (assuming you let her drive LOL, maybe that is a choice to you) not a Maserati.

2000 buck mortgage+insurance+Ptax+upkeep would be a like a <$250,000 home, where the hell is that??? Texas? We cant cram all the physicians in the country into one low cost state, this isnt a "choice", you dont have job offers from 20 different places all the time to pick and choose.
4K/month BARELY gets you in a 3 bedroom home in the most populous states, Im not talking a 7000SF mansion on 10 acres FFS.

Yes, if want to live like a bum OR have the fortune of marrying rich, maybe you have a "choice".

Once again the numbers I quote dont take into account someone drinking 20 year Sandeman port and smoking 25 dollah cigars every night.

Your comments really show you have a total dissociation from current economic realities.

 

[malchik]

Another economic reality is that length of training in a given field does and should not necessarily correlate with amount paid. Unless you think the biological sciences PhD's who have 6-8 year PhDs, plus 3-5 year postdocs should earn more than most physicians. It's the economic value of your training, not the length, that should determine how much you earn.

 

[mlw03]

LMAO....500 bucks a month is roughly the payments for 2 Honda Civics, one for you and a spouse (assuming you let her drive LOL, maybe that is a choice to you) not a Maserati.

2000 buck mortgage+insurance+Ptax+upkeep would be a like a <$250,000 home, where the hell is that??? Texas? We cant cram all the physicians in the country into one low cost state, this isnt a "choice", you dont have job offers from 20 different places all the time to pick and choose.
4K/month BARELY gets you in a 3 bedroom home in the most populous states, Im not talking a 7000SF mansion on 10 acres FFS.

Yes, if want to live like a bum OR have the fortune of marrying rich, maybe you have a "choice".

Once again the numbers I quote dont take into account someone drinking 20 year Sandeman port and smoking 25 dollah cigars every night.

Your comments really show you have a total dissociation from current economic realities.

nice home for less than a quater million... it's called the middle of the country. yes, people can live just fine without being within 50 miles of an ocean. if you choose to live in those most populous state (read: coasts) you pay for it in far higher housing costs. i understand Adam Smith too, LA. That's why I'm looking at many interior cities for residency - I choose to find that a viable option, and realize that may be important if i go into forensics.

not sure what the joke about letting women drive is about - i've never said anything remotely sexist on here because... i'm not sexist. my point was that 500 a month only has to be an issue for a set number of year, then you can maintain that car and save the 500 a month for at least 5 years. pretty much any car made nowadays should last 10 years, so getting one more frequently is a choice.

funny how the majority of comments from LA end up being about "bank" - I guess all I can say to that is "thank you" for working all those hours to earn all that money. i'll be glad to work reasonable hours (perhaps in forensics, where my salary would pale compared to yours and dermpathboy's), enjoy my job, and come home to a perfectly liveable house and then use some of that time to enjoy something in life not dealing with pathology or money.

 

[LADoc00]

Another economic reality is that length of training in a given field does and should not necessarily correlate with amount paid. Unless you think the biological sciences PhD's who have 6-8 year PhDs, plus 3-5 year postdocs should earn more than most physicians. It's the economic value of your training, not the length, that should determine how much you earn.

Most PhDs and postdocs are funded. There is a HUGE difference between making ~30K/year as a stipend for a PhD student and paying 50K a year for med school. Due to the wonders of compounding interest, far far more than the 80K swing might suggest.

For example, as a PhD candidate I racked up around 40K/year in income from a variety of funding sources (extra and intramural funds). With that I got health insurance, a retirement package, vision and dental. There is no risk WHATSOEVER in my doing that, if I wasnt doing a PhD I would be in some other crap 40K year job in private industry.

Now, imagine paying 200K as a sunk risk for med school and needing to cross over tons of barriers before you can turn 1 dollar of that investment into income. You have dozens of possible traps to fail out on from a premed position to where I am now.

The risk:benefit ratio between PhDs and MD is nowhere even close to the same. Time is really immaterial, what you are dealing with at the core is a concrete risk to benefit ratio and for forensics it is COMPLETELY out of whack. I would even go so far as to say it is worse than occupations like teaching, military service during peacetime and general civil service.

 

[LADoc00]

nice home for less than a quater million... it's called the middle of the country. yes, people can live just fine without being within 50 miles of an ocean. if you choose to live in those most populous state (read: coasts) you pay for it in far higher housing costs. i understand Adam Smith too, LA. That's why I'm looking at many interior cities for residency - I choose to find that a viable option, and realize that may be important if i go into forensics.

not sure what the joke about letting women drive is about - i've never said anything remotely sexist on here because... i'm not sexist. my point was that 500 a month only has to be an issue for a set number of year, then you can maintain that car and save the 500 a month for at least 5 years. pretty much any car made nowadays should last 10 years, so getting one more frequently is a choice.

.

OMG, that is funny. So basically the CORE OF YOUR ARGUEMENT rests on the fact somewhere in central Okalahoma you can get a killer pad for 250? Then, who the hell is going to do forensics in LA, NYC and Boston where people actually GET MURDERED??? LOL!!!!! Yes, FP is great where 1.) the cost of living is dirt low 2.) there is no crime......the logic is brilliant really.

A majority of my comments have nothing to do with "bank", but if you want to believe that then fine. Im trying to interject reality into this thread but I will cease now.

 

[Mindy]

LA must be a frustrated forensic pathologist at heart! And his attack about not caring about the middle class sounds a lot like he stole it from one of the recent campaign debates---maybe he should consider politics! Sorry LA, a car is a luxury I cannot afford, so I ride my bike to work... And, yup, I still love what I do.

Now that I am finally practicing forensics, I can say with assurance that there is NO WAY I could perform this job without being a pathologist, let alone a physician. The thought of managing to become a medical examiner without the training is absurd. It is very easy for residents to think that the work of a medical examiner stops once they leave the morgue, since that is really all they are usually exposed to. And I suspect that is all LA knows about it. But as I sit here at my desk I feel nothing short of an internist of the deceased--waiting for my culture results and toxicology reports, looking at my slides, reviewing x-rays, sifting through vats of medical records, and explaining to family, police, and district attorneys why respective loved ones and/or victims died. I would love to see someone without the training give it a whirl, because it is hard enough with the training to figure out the cause and manner of death.

(Great to hear from you as well gungho! It has been a long long time! Hope all is going well!)

Mindy

 

[pathstudent]

My only problem with forensics is that it is so unacademic. Where I did my rotation a few months ago, they did 20-30 posts a day and it felt like a factory where we just cut em and gut em. Cases took only 60 minutes and everything was pending toxicology. IMO, all forensics programs should be under the umbrella of academic instutions where they have experts in cardiac pathology, pulmonary pathology, renal pathology, and routine sections should be taken on every case for no other reasons than academic principle and resident education.

 

[mlw03]

OMG, that is funny. So basically the CORE OF YOUR ARGUEMENT rests on the fact somewhere in central Okalahoma you can get a killer pad for 250? Then, who the hell is going to do forensics in LA, NYC and Boston where people actually GET MURDERED??? LOL!!!!! Yes, FP is great where 1.) the cost of living is dirt low 2.) there is no crime......the logic is brilliant really.

A majority of my comments have nothing to do with "bank", but if you want to believe that then fine. Im trying to interject reality into this thread but I will cease now.

the core of my argument is life is about choice and balance. i accept the former and strive for the latter. i don't know who does FP in major cities, but i'm guessing they make more money to compensate for the higher cost of living there. ya know, i would imagine you could find a general pediatrician in NYC also and they're not making huge money either. when one chooses to live in a major city, one does so with the understanding that they will enjoy certain benefits of being there and also make financial sacrafices. so again (since you seem to repeatedly miss my main point), the core argument here is choice, and that adults can choose whatever they feel is best for their lives.

 

[pathstudent]

the core of my argument is life is about choice and balance. i accept the former and strive for the latter. i don't know who does FP in major cities, but i'm guessing they make more money to compensate for the higher cost of living there. ya know, i would imagine you could find a general pediatrician in NYC also and they're not making huge money either. when one chooses to live in a major city, one does so with the understanding that they will enjoy certain benefits of being there and also make financial sacrafices. so again (since you seem to repeatedly miss my main point), the core argument here is choice, and that adults can choose whatever they feel is best for their lives.

In medicine everything is backwards. If you were a real estate developer or bank manager or an engineer, you can make a lot more money in a big city than a small city, but for medicine it is the opposite, especially on the west coast.

The salaries for physicians in LA are the probably the lowest in the country and it is arguably tied with SF as the second most expensive metro in the country. Even in academics it is true. When I was a medical student, our path mentor told us that the average salary of an academic pathologist was about 200K, but said it was much lower on the west coast (150K), because so many people are so desperate to live in LA. People will do whatever it takes to get there.

 

[Brian Pavlovitz]

Imagine: there is a subgroup of people out there with wonderous and magical things called "trust funds" who dont have to worry about making a 1500 buck student loan payment, 500 bucks in car payments and a 4000 buck mortgage each month in addition to feeding a family.

Imagine: You are a working class guy with a wife who doesnt work and takes care of the kids and you are solely responsible for the household income.

Lets not get all high and mighty Brian because there are actually middle class readers of this forum out there that are stressing about the current economic climate of healthcare.

Apparently I hit a nerve. Didn't mean to get "high and mighty" on you; just making an observation is all. I'm in debt up to my ears, and will be for a long time after residency.

 

[malchik]

The risk:benefit ratio between PhDs and MD is nowhere even close to the same. Time is really immaterial, what you are dealing with at the core is a concrete risk to benefit ratio and for forensics it is COMPLETELY out of whack. I would even go so far as to say it is worse than occupations like teaching, military service during peacetime and general civil service.

That was my point, that amount of training time alone is not an argument for what one should be paid; rather, what that training allows one to contribute to the marketplace. Your point about economic risks associated with private med school is well taken, but I strongly disagree that there are a greater number of "possible traps to fail out on" and barriers to generating income for MDs vs. PhDs. You really think there are more failed and unemployed MDs than PhDs? If worst case for an MD is a medical examiner job at 150K, and worst case for a PhD is an endless postdoc or untenured professor job at, generously, 60K, the medical examiner comes out on top even starting with 200K in the hole.

 

[LADoc00]

Apparently I hit a nerve. Didn't mean to get "high and mighty" on you; just making an observation is all. I'm in debt up to my ears, and will be for a long time after residency.

Well then rise up in the revolution with me! If Hillary pushes her unversal healthcare model, then she also needs to tell her Wall Street banking buddies they arent getting their student loans from us.

 

[Sweenracer]

2000 buck mortgage+insurance+Ptax+upkeep would be a like a <$250,000 home, where the hell is that??? Texas? We cant cram all the physicians in the country into one low cost state, this isnt a "choice", you dont have job offers from 20 different places all the time to pick and choose.
4K/month BARELY gets you in a 3 bedroom home in the most populous states, Im not talking a 7000SF mansion on 10 acres FFS.

I have to laugh everytime I see the ridiculous cost of living people pay in California, New York City, etc...

I am not a doctor I am an Engineer, my wife is a resident making $40k a year and I have a house in Upper Dublin, a Philadelphia Suburb with top rated schools, 30 minutes to center city Philly, 1/2 acre property, 2000 sq. ft., 3 bedrooms, bought it last year for $300k, my mortgage is roughly $2k a month. Pennsylvania is quite populous, Philadelphia has many oppurtunities for docs, and only an hour drive to NYC. Can't beat it. All y'all Cali people are *****s.

 

[dwil75]

loan repayment - not a choice

$500 car payment - choice. No one is going to force me to get rid of my perfectly functional Mazda when i graduate and pick up a Lexus with a much higher payment. Also, no one says I have to get a new car every 3 years instead of paying off a car and then having no payments for 5 years. These are choices.

$4000 mortgage - again, a choice. You can easily afford a beautiful home for half that in most places in this country - just not LA, San Fran, Boston, NYC, and maybe a few others. Living in these places is also a choice, and in exchange for living in a more "desireable" location you're going to pay for it.

You talk about middle-class members of this forum, but then you make it sound like someone making $160K per year would struggle to make ends meet. that's just absurd. standard of living is about choice, and the choices we make determine how much we have to work to attain what's important to us. for those in medicine who decide enjoying what they do is more important than bringing home enough money to have every material possession under the sun, i say good for them. and for people who want to work 75 hours per week and make $800K per year, good for them too. but we all should be respectful of each other's choices and accept them as they are.

Well stated. 👍

 

[Mindy]

I have to laugh everytime I see the ridiculous cost of living people pay in California, New York City, etc...

I guess, but Boston is a really really cool place to live IMHO.

Mindy

 

[Trenchcoat]

AFAIK AP/FP doesn't exist. If it did, I'd do it too.

 

[mlw03]

AFAIK AP/FP doesn't exist. If it did, I'd do it too.

AP/FP exists, formally at least, only at 1 program to my knowledge: UTSW. I spoke with the PD about it and he told me that he can't recall anyone ever actually doing it. I thought about trying to do it, either at UTSW or elsewhere via a unique curriculum, but in the end I decided the 1 extra year wouldn't be that bad. Plus, after speaking with a forensic pathologist, he advised me that the knowledge gained from the CP training would be beneficial and worth the time and effort.

 

[Trenchcoat]

Same. I've heard that CP is quite beneficial from every single ME I've talked to.

 

[Mindy]

I am finding my CP training invaluable. We spend a lot of time interpreting postmortem lab tests. Knowing what testing is available and how the testing actually works is very nice to have in your pocket.

Here's a for instance:

We use a dipstick screening test for morphine, cocaine, and thc metabolites at (???) morgue-side. We confirm all of these results via our toxicology lab with another screening immunoassay for a panel of drug classes. If drugs are detected on the formal screen, the sample is reflexed for quantitative and confirmatory analysis by GC-MS. It turns out that most screening immunoassays detect either benzoylecognine (cocaine's major metabolite) alone or BE + cocaine. The morgue-side test we use detects BE only.

Keep in mind that many medical examiners (including our jurisdiction) will not sign out a cause of death as acute cocaine intoxication unless cocaine (not just BE) is detected. (Any thoughts on this? Because I am not sure I buy into it yet to be honest...)

So the point is...it isvery helpful to know what your morgue-side screening test is actually detected versus what your toxicology lab is detecting so that when your dipstick reads "Positive for cocaine", you are not surprised when the tox lab finds only the metabolite.

It is just one simple scenario, but it is easier to recognize these types of dilemmas if you have some lab path training.


Mindy

 

[deschutes]

Been at the ME's this month - while I'm glad to see my autopsy #'s rising so quickly especially with an international news-making event on top of the "usual" people killing themselves and each other, autopsies while important have never been my favourite thing to do (least of all day after day after day!).

Hospital-autopsy bowel is bad enough, but rotting bowel is a smell from the 7th circle of hell. And the morgue cooler. Lordy.

I'm glad there are people out there who really enjoy it, since it is a matter of public health.

 

[l&usibari]

LADoc, I usually find your posts pretty astute, but I think you are a little off the mark with your real estate and budget estimates. I own a nice 3 bedroom/2.5 bath house in the NE that cost me $135K. I drive a 6 yo fully paid for car. My husband's car is also fully paid for. I'm gonna have to take mlw's side on this one.