MD & DO Medical school debt is not nearly as bad as people make it out to be

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@tantacles

Not at this stage so I've tagged a friend who may refute me but from anecdotal experience of having my peers apply for hospitalist positions. Starting salary for a hospitalist of $300K seems to be wishful thinking unless it includes at least one desirable not limited to the below:

-Outside a desirable area
-Unsustainable work and/or locums (high burn out rate)
-Nocturnal

$200K-250K is more reasonable and even then there are tons of things to negotiate like malpractice, responsibilities, etc. If you find a $250K starting salary as a hospitalist 7-on/off gig with benefits, malpractice, etc. that you are satisfied with, I would take it and run.
10th percentile for MGMA hospitalist is $225k (n = 5,100 doctors)--that figure is not including benefits or malpractice which is standard for any employed job. You need to combine quite a few choices to get a 10th percentile salary, even for a new grad.

Also, "undesirable" area does not automatically mean a town of 5,000 in Alaska. In terms of getting a better salary, it means a city of a few 100,000 up to 1 million in states like Indiana, Tennessee, Alabama, Arizona, Wisconsin, Ohio, etc. Perfectly livable places with good schools and plenty to do. If you can't be happy in a place like that for a few years, that is 100% on you, not on the location. If the only place someone can be happy is a top 10 US city...just wow.

In fact, the truly rural places like critical access hospitals that people commonly imagine when they say "outside a desirable area" often pay about the same as "desirable" cities or less, because they are low volume. True BFE places are often where ED and hospitalist shifts are 24 hours (or even 48 hours!) because you have so much free time to sleep. You are not going to generate many RVU's so you don't make as much per hour (hence the government subsidizing CAHs, but still you get the point).
 
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Angus Avagadro

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I actually 100% agree with @Vivid_Quail , and I think you, like many other people in medicine are the ones missing the large point.

I am honestly sick of this tired excuse of “missing out on starting family, retirement/investments, savings, buying a home, etc etc etc...” These are excuses.

1. If you think you need to wait until you finish training to invest/contribute to your retirement, you obviously don’t invest.
The average diversified investment portfolio has historically performed at 8-9%/year return. You can literally use student loans in med school to invest and still make a profit.
In 2016, I was a med student and I gave my brother $500 (ALL student loan money at a rate of 6.8%) to invest in Tesla for me. I have enough from that to put a down payment on a house if I choose. And no, this was not “luck”. People who really care to be knowledgeable about investing and savings know that you do NOT have to “wait till you finish” to start your life or investments.
THIS is the problem with people in medicine, they want to make a **** ton of money at a young age, yet don’t know the first thing about money.
2. If you are graduating residency in 2021 and going into outpatient PCP or hospitalist to only take home 250k with a 300k or so loan burden, and you are NOT receiving any type of loan repayment from your job or through a FQHC, YOU are the one playing yourself.
3. Finally, I can not stress this enough - NEGOTIATE YOUR CONTRACT! 250k salary IS enough to pay off your loans. Negotiate loan repayment, negotiate daycare costs (my institution will not pay back loans but will cover full time day care at our institution)
4. Actually this is really the last point. Stop going into low paying specialties if you know you will have 400k in loans after training. I don’t care about your passion, you simply can not afford to be an outpatient pediatrician making $180k. And before the excuses start again about competitiveness- I matched anesthesia with a 202 step 1. I plan on staying at my home program after graduating, current contracts going for $500k base rate, yes major city.
Never borrow money to invest. It's merely gambling. Might as well borrow money and go to Vegas to play roulette. Put it all on the red. Its just under a 50 50 bet. Makes about as much sense. Yes, not all doctors are good with money.
 
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Never borrow money to invest. It's merely gambling. Might as well borrow money and go to Vegas to play roulette. Put it all on the red. Its just under a 50 50 bet. Makes about as much sense. Yes, not all doctors are good with money.
I don't know...my friend has this amazing opportunity for time-shares in Las Vegas. I could tell you more about it if you could give me 5 minutes of your time!
 
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10th percentile for MGMA hospitalist is $225k (n = 5,100 doctors)--that figure is not including benefits or malpractice which is standard for any employed job. You need to combine quite a few choices to get a 10th percentile salary, even for a new grad.

Also, "undesirable" area does not automatically mean a town of 5,000 in Alaska. In terms of getting a better salary, it means a city of a few 100,000 up to 1 million in states like Indiana, Tennessee, Alabama, Arizona, Wisconsin, Ohio, etc. Perfectly livable places with good schools and plenty to do. If you can't be happy in a place like that for a few years, that is 100% on you, not on the location. If the only place someone can be happy is a top 10 US city...just wow.

In fact, the truly rural places like critical access hospitals that people commonly imagine when they say "outside a desirable area" often pay about the same as "desirable" cities or less, because they are low volume. True BFE places are often where ED and hospitalist shifts are 24 hours (or even 48 hours!) because you have so much free time to sleep. You are not going to generate many RVU's so you don't make as much per hour (hence the government subsidizing CAHs, but still you get the point).
Once again, that 10th percentile is across all hospitalists (per our earlier exchange). Its very possible that's average for brand new hospitalists while those with 5+ years experience could be closer to 300k.
 

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I knew once I mentioned Tesla, many of your would miss the point entirely.
Even if I pointed to a stock that would do only 2-3x in the next 4 years, most med students, residents, and attendings would just complain and make excuses about how “they can’t invest because of their lack of income as a med student or crazy med school debt or blah blah...”
The point I’m making is that people in medicine need to stop making the excuse of “being behind”
And yes, my $11,323.98 from Tesla is enough to put a down payment on a house because physician loans are 0% down and I only need 5% because I’m building. (Building a very modest house, at that. But let me guess, half of y’all also think just, because you trained for so long you also need a 500k-1M “doctor house”)

Once again proving my point that studying medicine does not stop you from investing, saving, or buying a house. It forces you to be smart, methodical, and disciplined in your decisions.
Again, please point me in the direction of the stocks that will "2-3x" in the next 4 years...with those returns perhaps you should reconsider a career in medicine and pursue finance instead. Perhaps some light reading below will enlighten you
 
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VA Hopeful Dr

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This is categorically false in the major metropolitan city that I live in. Hospitalists signing on for less than 300k do so for one of two reasons:

1) they are uninformed
2) they are not good at negotiating contracts
And your numbers are categorically false in the 3 places my wife and I have worked (3/5 largest cities in SC).

My anecdote will fight yours behind the playground after school tomorrow.
 
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Splenda88

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Here's the thing: you can have a lower-end physician job while saving for retirement, paying off loans, and have a decent lifestyle. My wife is also a physician and when I started my practice I didn't earn any money for about 6 months. So she was the sole breadwinner at the number I mentioned earlier. We had a nice house, a nanny for the kids, contributed to her 401k, took 1-2 trips/year, got take out 1-2x/month, and shopped at the nice grocery store. Granted her loans were only about 200k, but salaries are higher now than they were then.
You have a nanny! You are a baller man...
 
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Once again, that 10th percentile is across all hospitalists (per our earlier exchange). Its very possible that's average for brand new hospitalists while those with 5+ years experience could be closer to 300k.
I was using 10th percentile as a proxy for new grads because I figured that a new grad in a rural area could get more than 10th percentile for all hospitalists.

Anyways, I found a better source:

Hospitalist$170,000 (low)$254,000 (average)$349,000 (high)

This is from Merritt Hawkins 2020 data for new grads. It is in the MLOC calculator which is something AAMC gives to med students for free...otherwise I think it is behind a paywall. I don't know if Merritt Hawkins is as reliable as MGMA, but at least this data is for new grads. This is also base salary, so if you pick up 2-3 extra shifts a month for a nice internal moonlighting premium ($180-200/hr), you can pump that up.

A big part of my thesis, if you can call it that, is that if you are serious about getting your debt under control, you don't want to settle for "average" new grad compensation. 26% of MD students graduate with $0 in student loans and 46% graduate with <$150k (includes the $0 debt people). Let those debt-free or low debt folks take the low to average paying hospitalist jobs for new grads--they can afford it. If you are in a lot of debt, hunt for a job that is more towards the high end of the Merritt Hawkins data.

Source for debt %'s: Average Student Loan Debt for Medical School for 2021
 

Quantal Reasoning

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Again, please point me in the direction of the stocks that will "2-3x" in the next 4 years...with those returns perhaps you should reconsider a career in medicine and pursue finance instead. Perhaps some light reading below will enlighten you

Liberal propaganda. If no one is better than anyone, then all success is luck.

The harder I work, and the more research I do, the better I do.
 

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How much do IM hospitalists get as a fresh grad with 0 years of experience? I was under the impression that 250-300k is common but I guess it’s not
It's common... Almost all my co-residents have signed for 250-300k/yr for hospitalist. 300k+ are for nocturnists. I only know one person that signed for ~210k in a major city and it's academia.
 
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Liberal propaganda. If no one is better than anyone, then all success is luck.

The harder I work, and the more research I do, the better I do.
Lol, this is hilarious because you are trying to make a point that sounds too ridiculous to be true, except it has been shown that timing the market is luck for >99% of people, even more so for average joes like us.

It is an accepted fact by conservative economists and conservative financial guys that the majority of professionals can't beat the market consistently. The funds that do beat the market consistently are not accessible for people with NWs <100MM. So unless you are a physician named Dr. Oz, buying and holding a low cost index fund is the evidenced based way to increase your NW the fastest. Even with a 9-figure net worth, the few objectively successful funds are incestuous and play mostly with money of the guys working at the fund.

If you really are desperate to take a little more risk and try to beat the historical inflation adjusted average returns of 7-8%, buy and hold low cost index funds on margin with 1.1-1.3x (10-30%) leverage using IBKR (1.07% interest on 100k-1MM of leverage). Pretty impossible to get margin called unless there is a 70%+ crash, which at that point, everyone is ****ed.
 
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Good private schools are 20k+/yr... Isn't it better to use that money to pay for a mortgage in a wealthy neighborhood with good public schools?
Generally yes, but South Carolina has famously bad public schools...not that I would know:censored:
 
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Splenda88

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The fact of the matter is: If you are making 300k/year and your total student loan is 300k, you are doing well financially...

Let's say you max out your 401k and HSA and back door Roth IRA, you will bring home ~170k+/yr or 14k/month. 4k/month to pay off student loan, you still have left 10k/moth to pay your bills...

Maxing out your 401k/HSA/Roth(back door) will net you a retirement of 3.5 mil after 30 yrs of working (8% market return)... So physicians have better than 95%+ of the population.
 
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VA Hopeful Dr

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Good private schools are 20k+/yr... Isn't it better to use that money to pay for a mortgage in a wealthy neighborhood with good public schools?
10k at their age. The local public schools (same ones I went to 20+ years ago) don't offer full day 4k. And now that we're their and the girls absolutely love it, we're stuck.
 
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Neopolymath

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"Other people made do with way less so doctors shouldn't ever complain"

You're on a roll today.
This is the downfall of our profession and hell it's coming from within as much as from laypeople these days.
 
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This is the downfall of our profession and hell it's coming from within as much as from laypeople these days.
I know it is crazy. I heard all of the doctors left Europe once they started making under $200k/year.

Physicians in the US earn a fair salary, there are even good arguments that it should be higher, but "the downfall of our profession" is drama that deserves to be on Broadway.
 
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Neopolymath

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I know it is crazy. I heard all of the doctors left Europe once they started making under $200k/year.

Physicians in the US earn a fair salary, there are even good arguments that it should be higher, but "the downfall of our profession" is drama that deserves to be on Broadway.
Sure, bud. Go ahead and be a whipping boy and ironically tell people they lack perspective. I won't stop you.
 

Splenda88

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I know it is crazy. I heard all of the doctors left Europe once they started making under $200k/year.

Physicians in the US earn a fair salary, there are even good arguments that it should be higher, but "the downfall of our profession" is drama that deserves to be on Broadway.
It could be better... We all want to work 16 hrs/wk and make 200k+/year like that EM doc at the hospital I am doing residency now and be able to say: "I love my gig." :)
 

Neopolymath

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It could be better... We all want to work 16 hrs/wk and make 200k+/year like that EM doc at the hospital I am doing residency now and be able to say: "I love my gig."
Hey, man. Because euro docs don't want to leave Europe for complex reasons you need to shut up and take what you get because someone somewhere has it worse than you. You jerk!

/S

It's no wonder that a lot of erosions of medicine have come under the watch of boomers selling out the profession followed by perhaps the biggest group of doormats the world has seen in modern medical students.
 
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Hey, man. Because euro docs don't want to leave Europe for complex reasons you need to shut up and take what you get because someone somewhere has it worse than you. You jerk!

/S

It's no wonder that a lot of erosions of medicine have come under the watch of boomers selling out the profession followed by perhaps the biggest group of doormats the world has seen in modern medical students.
who hurt you
 
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And your numbers are categorically false in the 3 places my wife and I have worked (3/5 largest cities in SC).

My anecdote will fight yours behind the playground after school tomorrow.
Well then I suggest you move. My "anecdote" is from a stream of residents signing contracts over the last 4 years. I've probably seen a dozen or more contracts signed for 1st year attending hospitalist positions and none have been below 300k. At least 5 were from graduates of the FM program.

I'm sorry you chose to live in a crappy state? I don't really know what else to say to your attempt at "one-upping" me. Or, in this case, "one-downing" me 🙄

There is plenty of opportunity for lucrative positions in FM, right out the gate from residency. Even if some family docs choose not to believe it.
 
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It could be better... We all want to work 16 hrs/wk and make 200k+/year like that EM doc at the hospital I am doing residency now and be able to say: "I love my gig." :)
I think everyone can agree that $260/hour for EM is going to go away very fast and leave a lot of EM doctors very unhappy with their career choice. But for now, an hourly salary higher than most ortho surgeons is indeed pretty sweet when you can combine it with part-time shift work. I wouldn't bet on that lifestyle being possible in 5 years though haha
 

Splenda88

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I think everyone can agree that $260/hour for EM is going to go away very fast and leave a lot of EM doctors very unhappy with their career choice. But for now, an hourly salary higher than most ortho surgeons is indeed pretty sweet when you can combine it with part-time shift work. I wouldn't bet on that lifestyle being possible in 5 years though haha
Yeah... I feel bad for them. HCA is bringing EM down to its knees.
 
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This falls on deaf ears when you have a group of people who work their asses off for a long time and sacrifice plenty only to have to wait until they are 40 until they are near a net worth of zero. Simply looking at the final salary is the stupidest **** I’ve seen on here in a while. Docs are underpaid. This perspective becomes clearer the further along the path you go while your non-med peers are getting wealthy often doing nonsense.
 
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This falls on deaf ears when you have a group of people who work their asses off for a long time and sacrifice plenty only to have to wait until they are 40 until they are near a net worth of zero. Simply looking at the final salary is the stupidest **** I’ve seen on here in a while. Docs are underpaid. This perspective becomes clearer the further along the path you go while your non-med peers are getting wealthy often doing nonsense.
This.

Looking at final salary only is so dumb. OP is forgetting opportunity cost and other stuff like malpractice insurance. 4 years of 0 income and then 3-7 years of low income is a lot of edge lost. Then there is money that would have grown if it was invested like it should be. If you go straight to med school from undergrad, you really only have residency to contribute to a Roth IRA (which is better than a trad). The OP is ignoring that just to be "on track" for retirement you'd have to contribute a lot more money than someone at the same income level who didn't have all of the hurdles associated with med school.

I hate hearing stuff like "oh well 150k is still more than anything my [poor] family has ever seen". Like ok? Not knowing what you are worth is what is causing the decline of the profession in the first place. In a wider sense, it is what is causing wage stagnation in America in general.

I'm going to med school as a nontrad in my late 20s, and when I did my last check I won't even break even til I'm in my 50s. If I stuck to my current career, I could retire at 40.
 
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VA Hopeful Dr

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Well then I suggest you move. My "anecdote" is from a stream of residents signing contracts over the last 4 years. I've probably seen a dozen or more contracts signed for 1st year attending hospitalist positions and none have been below 300k. At least 5 were from graduates of the FM program.

I'm sorry you chose to live in a crappy state? I don't really know what else to say to your attempt at "one-upping" me. Or, in this case, "one-downing" me 🙄

There is plenty of opportunity for lucrative positions in FM, right out the gate from residency. Even if some family docs choose not to believe it.
I spend most of my time here talking about how much family doctors can make (basically as a whole I agree that it can be a very lucrative field). Heck, I'm on track to hit 400k this year working 36 hours/week outpatient FM. But even I recognize that this is above the norm (I'll be around 85th percentile MGMA to manage this).

I have no doubt there are also very lucrative FM hospitalist jobs as well, but also not the norm. Two different sources were cited above saying that the median was less than 300k.
 
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People who move goal posts and people who trip over each other to be the med student who gives away the most self-respect to virtue signal.
Who moved the goal posts? Who is virtue signaling in this thread? Who is being a whipping boy? You sound like someone who just heard some phrases on a conservative podcast and repeats them without knowing that they mean.
 
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This.

Looking at final salary only is so dumb. OP is forgetting opportunity cost and other stuff like malpractice insurance. 4 years of 0 income and then 3-7 years of low income is a lot of edge lost. Then there is money that would have grown if it was invested like it should be. If you go straight to med school from undergrad, you really only have residency to contribute to a Roth IRA (which is better than a trad). The OP is ignoring that just to be "on track" for retirement you'd have to contribute a lot more money than someone at the same income level who didn't have all of the hurdles associated with med school.

I hate hearing stuff like "oh well 150k is still more than anything my [poor] family has ever seen". Like ok? Not knowing what you are worth is what is causing the decline of the profession in the first place. In a wider sense, it is what is causing wage stagnation in America in general.

I'm going to med school as a nontrad in my late 20s, and when I did my last check I won't even break even til I'm in my 50s. If I stuck to my current career, I could retire at 40.
I would like to see actual numbers where someone in a different profession comes out ahead of an average physician in terms of spendable income at ages 35-retirement and has a higher NW at retirement. Since you will probably pick CS, finance, or business, remember, you have to compare apples to apples (averages to averages). If you use a hedge fund manager or FAANG upper management guy, it is just as fair for me to counter with an ortho spine surgeon's finances...all of those fields are equally rare and competitive in their broader profession.
 
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Chibucks15

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I would like to see actual numbers where someone in a different profession comes out ahead of an average physician in terms of spendable income at ages 35-retirement and has a higher NW at retirement. Since you will probably pick CS, finance, or business, remember, you have to compare apples to apples (averages to averages). If you use a hedge fund manager or FAANG upper management guy, it is just as fair for me to counter with an ortho spine surgeon's finances...all of those fields are equally rare and competitive in their broader profession.
My friend is in commercial real estate at a big firm in a large city. I gave him numbers of loans and used a salary of 250k. Even with starting as late as I will be i out earn him by almost 10%. Given that 250 is pretty easily attainable in medicine, and his job is probably like 75th percentile kinda thing. The journey to medicine is terrible but there isn’t a thing that compares to it. Add on job security and it really doesn’t match anythnf
 
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My friend is in commercial real estate at a big firm in a large city. I gave him numbers of loans and used a salary of 250k. Even with starting as late as I will be i out earn him by almost 10%. Given that 250 is pretty easily attainable in medicine, and his job is probably like 75th percentile kinda thing. The journey to medicine is terrible but there isn’t a thing that compares to it. Add on job security and it really doesn’t match anythnf
Real estate broker 90th percentile salary is $163k, real estate agent 90th percentile is $112k. Median is $58k and 48k respectively. Otherwise I agree completely.

Sources: Real Estate Brokers https://www.bls.gov/oes/2018/may/oes419022.htm
 

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Real estate broker 90th percentile salary is $163k, real estate agent 90th percentile is $112k. Median is $58k and 48k respectively. Otherwise I agree completely.

Sources: Real Estate Brokers https://www.bls.gov/oes/2018/may/oes419022.htm
Commercial real estate that he does isn’t a broker. Very different. He’s corporate and doing multi million/billion dollar deals on things. Not a normal real estate agent. Regardless it was a ballpark in terms of percentile compared to “normal” jobs
 

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Real estate broker 90th percentile salary is $163k, real estate agent 90th percentile is $112k. Median is $58k and 48k respectively. Otherwise I agree completely.

Sources: Real Estate Brokers https://www.bls.gov/oes/2018/may/oes419022.htm
BLS is a terrible source. Go look at their numbers for physicians... not even close.

I know someone who posted on FB about how she cleared 30 MILLION in sale/purchase volume as a real estate agent for 2020. At a 3% commission that puts her at having earned $900,000 for the year. Obviously there are other costs involved with being an agent, and I believe I heard someone say it's like 25%. That would mean she brought home $675,000 before taxes. Oh and she's like 26 or 27 with no debt.

Obviously she is an outlier as I'm sure most real estate agents don't make that much but DAMN do I get jealous whenever I see her post stuff like that. Oh and I'm 99% sure she works like all hours of the day and night in dedication to her job, so I don't think it's exactly a "lifestyle" job in the way she does it. But still, real estate is most definitely a path to the good life if you know what you're doing.
 
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BLS is a terrible source. Go look at their numbers for physicians... not even close.

I know someone who posted on FB about how she cleared 30 MILLION in sale/purchase volume as a real estate agent for 2020. At a 3% commission that puts her at having earned $900,000 for the year. Obviously there are other costs involved with being an agent, and I believe I heard someone say it's like 25%. That would mean she brought home $675,000 before taxes. Oh and she's like 26 or 27 with no debt.

Obviously she is an outlier as I'm sure most real estate agents don't make that much but DAMN do I get jealous whenever I see her post stuff like that. Oh and I'm 99% sure she works like all hours of the day and night in dedication to her job, so I don't think it's exactly a "lifestyle" job in the way she does it. But still, real estate is most definitely a path to the good life if you know what you're doing.
BLS data for physicians includes residents, that is why they are deflated. Residents make like $50-80k and there are 140,000 of them in the US.

Hahahahaha at your 1 in 10,000 anecdote. Are you seriously using an anecdote from Facebook in an argument about career choices? The vast majority of real estimate agents will never even clear $100k.
 
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Quantal Reasoning

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Lol, this is hilarious because you are trying to make a point that sounds too ridiculous to be true, except it has been shown that timing the market is luck for >99% of people, even more so for average joes like us.

It is an accepted fact by conservative economists and conservative financial guys that the majority of professionals can't beat the market consistently. The funds that do beat the market consistently are not accessible for people with NWs <100MM. So unless you are a physician named Dr. Oz, buying and holding a low cost index fund is the evidenced based way to increase your NW the fastest. Even with a 9-figure net worth, the few objectively successful funds are incestuous and play mostly with money of the guys working at the fund.

If you really are desperate to take a little more risk and try to beat the historical inflation adjusted average returns of 7-8%, buy and hold low cost index funds on margin with 1.1-1.3x (10-30%) leverage using IBKR (1.07% interest on 100k-1MM of leverage). Pretty impossible to get margin called unless there is a 70%+ crash, which at that point, everyone is ****ed.

You are welcome to believe whatever you like.
 

fldoctorgirl

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He is pathologically committed to his "rice and beans, no debt ever, grind until you drop dead from work" shtick.
Not speaking just about Dave Ramsey, but I am really against this mentality. I want to pay off my debt quickly (and will have over 300k), but I also don't plan on living in squalor. Will I buy a 1M house or a Mercedes? No. But I'm not going to live like a homeless person so I can pay my debt off in 3 years instead of 5. A lot of people perpetuate this idea on here that it's either live in filth or start buying 1M homes, but I think the real happy place is somewhere in the middle. At least, for most people. Power to someone if they want to live on ramen and rent a 500 sqft apartment to shave a couple of years off their repayment.....but nah. I also don't understand why he is so vehemently against CC debt. If you pay off your entire bill each month, you can't argue against the benefits CCs provide.

Anyways, this has been an interesting thread to read, so thanks for sharing your info :) I am working on educating myself more regarding personal finance and I do think the point of your post is true: most of us don't really know much about this stuff.
 
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Not speaking just about Dave Ramsey, but I am really against this mentality. I want to pay off my debt quickly (and will have over 300k), but I also don't plan on living in squalor. Will I buy a 1M house or a Mercedes? No. But I'm not going to live like a homeless person so I can pay my debt off in 3 years instead of 5. A lot of people perpetuate this idea on here that it's either live in filth or start buying 1M homes, but I think the real happy place is somewhere in the middle. At least, for most people. Power to someone if they want to live on ramen and rent a 500 sqft apartment to shave a couple of years off their repayment.....but nah. I also don't understand why he is so vehemently against CC debt. If you pay off your entire bill each month, you can't argue against the benefits CCs provide.

Anyways, this has been an interesting thread to read, so thanks for sharing your info :) I am working on educating myself more regarding personal finance and I do think the point of your post is true: most of us don't really know much about this stuff.
Exactly. You don't have to live on ramen and in a small apartment as a resident (ok, well 500 sqft is actually pretty big for a resident in some cities), so doing it as an attending while paying off debt it just silly. That is why I ran the numbers with a 100% spending increase after graduating residency and paying it off in 3-5 years...gotta be realistic about the psychological aspect of paying off debt, and it sounds like you are realistic :)

I think the best way to do CC is with an Amex charge card...not called a credit card because you HAVE to pay it off at the end of the month. You can earn tons of rewards points and get other perks like airport lounges. Other reward point credit cards are fine too, you just have to be disciplined once you open a CC account. That isn't as hard when you have a high income and won't be tempted to use the credit card for things like bills like many lower income Americans do.
 
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You are welcome to believe whatever you like.
As are you. What I am claiming about timing the market is an objective fact on the level "vaccines work." It is weird for you to presumably believe in modern medicine but then fall for daytrader snake-oil salesmen theories. I guess some people want a get rich quick scheme no matter how smart they are :/
 
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Are your friends practicing in NYC or SF at an academic place?

I don't know of a single surgical specialty with a median salary of <400k other than gen surg breast and gen surg endocrine, which both have lifestyles better than your average anesthesiologist. CT surg is like $725k...ortho is $600-700k, neurosurgery is $750-800k . ENT, plastics, uro, and all gen surg sub-specialties not mentioned are >400k median.

If you count 4 year residencies like OBGYN and ophtho as surgical, they make just under 400k median.

It is fair to say that if you want to live in a desirable city you probably aren't going earn a median salary your first few years as an attending. But $275k for general surgery is like 20th percentile so you would need to combine no experience and being stubborn about location to get in that situation.
I don't know what nonsense MGMA is saying, but I assure you Ophtho makes 400k+ median.

I agree with most of the sentiment. Your numbers are a little strange and don't account for everything, however.

A little shocked people don't understand the basics of taxes. My family income is high 6 figures and I pay slightly less than 30% effective tax rate. And no weird tax tricks either.
 
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I don't know what nonsense MGMA is saying, but I assure you Ophtho makes 400k+ median.

I agree with most of the sentiment. Your numbers are a little strange and don't account for everything, however.

A little shocked people don't understand the basics of taxes. My family income is high 6 figures and I pay slightly less than 30% effective tax rate. And no weird tax tricks either.

Here is an example with sample numbers.
Screen Shot 2021-02-23 at 1.48.58 PM.png
Edit: Pre-tax deductions are the usual culprits. Maxed 401(k) for both me and spouse. HSA. Insurances.
 
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MissRibeye

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Exactly. You don't have to live on ramen and in a small apartment as a resident (ok, well 500 sqft is actually pretty big for a resident in some cities), so doing it as an attending while paying off debt it just silly. That is why I ran the numbers with a 100% spending increase after graduating residency and paying it off in 3-5 years...gotta be realistic about the psychological aspect of paying off debt, and it sounds like you are realistic :)

I think the best way to do CC is with an Amex charge card...not called a credit card because you HAVE to pay it off at the end of the month. You can earn tons of rewards points and get other perks like airport lounges. Other reward point credit cards are fine too, you just have to be disciplined once you open a CC account. That isn't as hard when you have a high income and won't be tempted to use the credit card for things like bills like many lower income Americans do.

AMEX is the best for so many reasons, but one of my favorite lesser-known reasons is that once you have an amex and open a SECOND one later, BOTH cards will show account ages based on the start of your FIRST card. The higher your average account age is, the higher your credit score.

This is why I opened an AMEX as soon as I was able and now I have a 13 year average account age. I can boost my score in the future by simply opening another AMEX card.

On living well with less . . . It is so easy, you just need to think a little longer and harder than the average person is willing to do, but it pays off huge. Learn some basic life skills and you can earn financial freedom far earlier.

I started learning about personal finance during my first job out of college, and eventually learned the joy of the game of figuring out how to live a comfortable middle class lifestyle for below-poverty-line wages (~14k/year) while also being able to travel, go out, etc. I just figured out where all of my money was going, made a priority list of things that made me happiest, and cut out or lowered all of the things that mattered to me the least. I learned how to cycle/walk/transit instead of drive (just not driving reduces expenses HUGELY), find unconventional but unique living situations, how to cook for myself, how to entertain myself without a ton of expensive streaming accounts, cell phone bills, and cable bills (library, 1 streaming account, playing board games with friends, hiking, camping, etc).

And now I have financial freedom, which is worth way more than being lazy and choosing the convenient, more expensive, and less imaginative solutions. With those skills I learned, I'm also more helpful to others and probably more interesting as a person, too.

Financial freedom is an amazing power that you can't fully understand until you earn it, but once you do, it's hard to understand why people would ever prioritize anything else outside of health and relationships. I wish I could just give the feeling to people for a few days so they'd understand why it's worth it.

This is all to say that I agree with the point that the debt isn't as scary as it needs to be, especially if you are strategic and creative because you can gain that financial freedom SO fast with the typical physician salary. I mean, students on this forum do so much research and come up with amazing strategies and tools to be able to learn a crapton of information in a short period of time; We have the ability to rock this too.
 
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I’m always astounded by people who are still certain their research methods and grit will translate into substantially beating the market, despite all the data that exists showing otherwise. I guess human nature is to associate every windfall to your own (“amazing”) capabilities. But can anyone actually show a 15/20 year investing history proving it?
 
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I’m always astounded by people who are still certain their research methods and grit will translate into substantially beating the market, despite all the data that exists showing otherwise. I guess human nature is to associate every windfall to your own (“amazing”) capabilities. But can anyone actually show a 15/20 year investing history proving it?
Considering they are probably in their early to mid 20s and joined WSB within the last year, I don't think they knew what a stock was 15-20 years ago.
 
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That is kinda cool but I do not think you can make any sort of argument from it...either for or against physicians having the most surefire path to wealth.

That source says 59k elementary and secondary school teachers and 32k secretaries are in top 1% households. I wouldn't recommend those two careers to someone who wants to have a 1% income...
 

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