Military doctor salary vs civilian?

[Septimusseverus]

Just looking for a source or something to give me a straightforward answer. I'd like to know the salaries for an average internal medicine doctor in the civilian world vs one in the military.

Assuming the civilian doc graduated from an out-of-state university. Also assume the military doc went to USUHS.

At the end of each year, how much money would each be taking home (when loans and everything are taken into account)?

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[BigNavyPedsGuy]

Impossible to answer that with the information given. In general the pay for civilian and military primary care is equivalent.

But nobody here knows what your loan total would be, what future interest rates will be, etc.

But it's been said multiple times - don't join for the money.

 

[Red Lobster Actual]

But it's been said multiple times - don't join for the money.

Too late, judging by previous posts OP has already raised his right hand.

To OP: Take average pay of internal med docs off of google. Then search this forum that discusses special pays and sum them together with basic pay, BAH, etc. Then calculate loan debt for the civilian doc. Then mash them together. I'm pretty sure you can do this yourself 🙂

 

[Marie-Curie]

You can do both you know ?

Anyway, medecine et military are two incompatible things from a moral point of view.

Referred to Hippocrate Otah

 

[ProudMD]

Just looking for a source or something to give me a straightforward answer. I'd like to know the salaries for an average internal medicine doctor in the civilian world vs one in the military.

Assuming the civilian doc graduated from an out-of-state university. Also assume the military doc went to USUHS.

At the end of each year, how much money would each be taking home (when loans and everything are taken into account)?

I'll give you some very rough numbers. If you want the exact figures, simply look them up.

Typically, internal medicine physicians (without fellowship training) make around 200k a year in the civilian sector. In the military, almost all doctors (after residency training) make in the low to mid 100k range. Unlike in the civilian world, the pay gap among different specialties is virtually non-existent in the military.

Basically, you will make a very comfortable, upper-middle class income as a military physician.

 

[Chonal Atresia]

"Unlike in the civilian world, the pay gap among different specialties is virtually non-existent in the military."

The ultimate socialized state of medical care. Everyone is equal - no matter how much your specialty actually demands in the free market and no matter how hard (or little) you work. You are rewarded solely on time in service and rank.

Good times!

 

[jabreal00]

Civilian internal medicine make anywhere from $180-250. The higher range are for those who are hospitalists or work in more rural areas. An internist in the military accounting for all the bonuses make about $130-150. The range accounts for BAH (which is none-taxed) which is higher in mid-atlantic/north east, Hawaii or some areas out west. The pay will go up incrementally as one progresses in rank. If one signs a multi-year bonus after 8 years of active duty service then the pay approaches parity with the civilian side high $100s to low $200s also dependent on rank and BAH.

 

[j4pac]

I believe that primary care is pretty similar when you consider lack of debt and all of the military benefits. But otherwise, you are taking a steep paycut. My buddy will be starting out over $300k doing Urology this year...that is more than twice the same that my Navy Urologist friend makes. So considering that there is a four year payback...you stand to lose about $150k per year in certain specialties. Considering that med school typically costs $250-350k...you can see how four years in the civilian sector can easily overcome the difference in cost of HPSP savings.

 

[pgg]

You can do both you know ?

Anyway, medecine et military are two incompatible things from a moral point of view.

Referred to Hippocrate Otah

Oh, do tell more.

 

[Chonal Atresia]

I believe that primary care is pretty similar when you consider lack of debt and all of the military benefits. But otherwise, you are taking a steep paycut. My buddy will be starting out over $300k doing Urology this year...that is more than twice the same that my Navy Urologist friend makes. So considering that there is a four year payback...you stand to lose about $150k per year in certain specialties. Considering that med school typically costs $250-350k...you can see how four years in the civilian sector can easily overcome the difference in cost of HPSP savings.

Remember also, this salary is just for the first 1-2 years. I have a similar salary guarantee this year; however, my partners are making b/t 500-700K/year.

You get hosed financially if you do any type of medical or surgical subspecialty in the military.

 

[TurtleDO2012]

When comparing things make sure you are comparing apples to apples. Looking at 1 year of civillian pay vs 1 year of miltiary pay greatly distorts the picture.

For the typical HPSP person think of the following-
Tuition is paid for each year of your chosen sholarship. A more expensive school you obviously benefit more than some one in a state school.
During the typical 3 year residency your total compensation will be around 70K but you don't pay taxes on BAH.
Then you have payback for residency pushing you to 100K-120K range for 3-4 years.

To make the financial compairson you really need to compare the 4 years of medical school, residency, and payback to ultimately determine the financial differences vs civillian. Ball park numbers can be determined without getting in weeds of interest on loans and difference in taxable pay.

Then the next comparison is really commit to stay in beyond your inital commitment. So basically have to decide if 13 more years is worth it. (using the format of a 4 year HPSP, 3 year residency, 4 year payback before free).
Say avg per year of active duty pay will place you around 150K which may be low for the remaining 13 years of service. Once you hit 20 years you'll achieve a 50% base pay retirement and free healthcare for yourself and your spouse. If you pass away I think your spouse gets a portion of your retirement and continues to get health care unless they re-marry.

Think of the pension as a very long annuity. Typical value for a Colonel of 21 years of service living for additional 30 years is valued at about 2.5 million, through in healthcare benefit and you are looking at 3-3.5 million worth of benefit.

For ease take 2.5 million/13 years = 192,000

Add 192,000 plus your avg active duty pay of 150K - 342,000 roughly avg for 13 years of additional service. Also during that time you would have to actually earn more to account for the fact that some states don't tax military pensions whereas you'll still pay income tax on earned and investments. Also while in military you could always go to an area to save on taxes or moonlight for more income.

During that 13 years of payback you can always do a fellowship or even another residency or both to break up that 20 year clock.

The Cost- you are in the military and numerous other posts can cite the costs of staying.

 

[j4pac]

Remember also, this salary is just for the first 1-2 years. I have a similar salary guarantee this year; however, my partners are making b/t 500-700K/year.

You get hosed financially if you do any type of medical or surgical subspecialty in the military.

Completely agree. I was going for the HPSP vs civilian angle. If someone is going primary care they will likely either be breaking even or being ahead at the end of their four year payback. The civilian will be ahead in any other specialty.

When comparing a twenty-year career...I believe that military PCMs may be close (considering retirement and benefits), but other specialties absolutely blow military docs out of the water.

It can't be reiterated enough that the military is a BAD idea for the money. Do it because you want to serve the great men and women of the military, and their families. Otherwise...it's usually a mistake.

 

[Chonal Atresia]

When comparing things make sure you are comparing apples to apples. Looking at 1 year of civillian pay vs 1 year of miltiary pay greatly distorts the picture.

For the typical HPSP person think of the following-
Tuition is paid for each year of your chosen sholarship. A more expensive school you obviously benefit more than some one in a state school.
During the typical 3 year residency your total compensation will be around 70K but you don't pay taxes on BAH.
Then you have payback for residency pushing you to 100K-120K range for 3-4 years.

To make the financial compairson you really need to compare the 4 years of medical school, residency, and payback to ultimately determine the financial differences vs civillian. Ball park numbers can be determined without getting in weeds of interest on loans and difference in taxable pay.

Then the next comparison is really commit to stay in beyond your inital commitment. So basically have to decide if 13 more years is worth it. (using the format of a 4 year HPSP, 3 year residency, 4 year payback before free).
Say avg per year of active duty pay will place you around 150K which may be low for the remaining 13 years of service. Once you hit 20 years you'll achieve a 50% base pay retirement and free healthcare for yourself and your spouse. If you pass away I think your spouse gets a portion of your retirement and continues to get health care unless they re-marry.

Think of the pension as a very long annuity. Typical value for a Colonel of 21 years of service living for additional 30 years is valued at about 2.5 million, through in healthcare benefit and you are looking at 3-3.5 million worth of benefit.

For ease take 2.5 million/13 years = 192,000

Add 192,000 plus your avg active duty pay of 150K - 342,000 roughly avg for 13 years of additional service. Also during that time you would have to actually earn more to account for the fact that some states don't tax military pensions whereas you'll still pay income tax on earned and investments. Also while in military you could always go to an area to save on taxes or moonlight for more income.

During that 13 years of payback you can always do a fellowship or even another residency or both to break up that 20 year clock.

The Cost- you are in the military and numerous other posts can cite the costs of staying.

I agree with your train of thought.

However, I personally would rather have the cash when I am younger (40s and 50s) and my expenses are much higher (kids, college, etc) than my 60s and 70s when I have no kids and low expenses. Also even with your numbers, you still come out way ahead financially as a PROCEDURAL medical and/or surgical subspecialist by NOT entering the military.

 

[JubalHarshaw]

You can do both you know ?

Anyway, medecine et military are two incompatible things from a moral point of view.

Referred to Hippocrate Otah

Stay in France, you cheese-eating surrender monkey.

 

[pgg]

TurtleDO2012, I agree almost exactly with this line of thought, and indeed it's how I calculated the financial difference between staying in and getting out when my educational obligation was up. However, I have two large quibbles with your assumptions and math.

First, it assumes retirement as an O6. The days when nearly everyone could count on pinning on a silver eagle if they stayed for 20 are absolutely, completely, categorically, totally OVER. Only around 50% make O5 their first time in zone these days. That's not to say you can't or won't make O6; just that most medical corps officers who retire at 20 or 21 probably won't. I think this kind of math should be done conservatively, assuming an O5 retirement grade.

Second, I think you significantly overvalue the cash value of the pension -

Think of the pension as a very long annuity. Typical value for a Colonel of 21 years of service living for additional 30 years is valued at about 2.5 million, through in healthcare benefit and you are looking at 3-3.5 million worth of benefit.

I don't think this is the correct way to estimate the value of a military pension, though I'd be interested in how you arrived at that number and if you're doing any kind of inflation adjustment (which I think would be wrong for this specific purpose).

I also am not prepared to buy off on the notion that the lifetime healthcare benefit is worth $500K to $1 million ... for the simple reason that I think it'll actually be worth nothing, because I believe by the time I get there, the USA will have some form of nationalized healthcare for all and EVERYONE will have Tricare- or Medicare-caliber health insurance. IOW, I don't believe I'll gain anything, health-insurance-wise, over any random hobo on the street who didn't do 20 in the military.


But to get to the math ... most simply, if you just do the math for the 30-year payout in retirement, an O6/21y pension would be high-36 base pay ($9272 + 9272 + 9721 / 3) x .525 (21y high-36 retirement multiplier) x 12 months x 30 years = $1,780,695. But that's not quite right, too simplistic.

You could estimate a cash value, including inflation adjustments, by buying the right number of TIPS to match the pension payout, then using your psychic powers to time your death perfectly and die broke. Or you could use the CDC's life expectancy tables and buy enough TIPS to take you until the day you're scheduled to die, Logan's Run style. This is a stupid way to plan for retirement 🙂 but as an estimate of a pension's cash value it has a lot of merit.

But I think the most correct way to estimate the cash value of a pension on the date of retirement from the military (which is the figure you want, when making get-out vs stay-in calculations) is the lump sum CASH cost of an inflation indexed single premium immediate annuity (SPIA), because that's what military retirement pay is: an annuity, with some kind of inflation or cost of living adjustment, that pays for the rest of your life, and then has zero value when you die.

When I did the math, a bit over a year ago using the 2013 pay tables and a 2013 online SPIA quote, these are the numbers I came up with for my projected situation. I anticipate retiring as an O5, with high-36 pay (and note that's the >16, >18, >18 lines ... remember high-36 is NOT just three times >20 pay!), and a 25-year retirement multiplier (my USUHS kicker).

$1,641,147 best estimate: A CPI-indexed SPIA for a 55-yo male paying $60,322/y ($3676/y per $100,000 premium).
$1,169,031 lower bound: A non-indexed SPIA for a 47-yo male paying $60,322/y ($516/y per $10,000 premium).
$2,050,948 upper bound: Buy TIPS, time my death perfectly, die broke. Provides an inflation-adjusted $60,322/y for 34 years.

Add 192,000 plus your avg active duty pay of 150K - 342,000 roughly avg for 13 years of additional service. Also during that time you would have to actually earn more to account for the fact that some states don't tax military pensions whereas you'll still pay income tax on earned and investments. Also while in military you could always go to an area to save on taxes or moonlight for more income.

In my case, I was eligible to get out at 12 years, so I divided the above $1.6 million by the 8 additional years needed to "vest" in the military pension, or $200,000 per year.

An O5 >12 to >18 under 4-year MSP in my specialty earns roughly $250-275K/year. Adding in a couple of tax benefits to being in the military (BAH, and not having to pay a 5-10% state income tax) brings that to $290-315K or so, plus the $200K of value each year "vests" in the pension, I estimated the value of my Navy pay during those final eight years at roughly $490-515K per year.

Plus some nebulous, very hard to estimate 'value' to the lifetime healthcare benefit for me and my wife. Which, as I noted above, may or may not really be worth anything. But it deserves some consideration.


Civilian jobs paying $500K can be had in my specialty (anesthesiology), but the outlook for them being around for the next 8 years isn't so rosy. The ones that will pay that tend to have some drawbacks ... high CRNA supervision/direction ratios, lots of call, a high hospital subsidy (dangerous to count on), high hours. I don't have any real networking connections (outside SDN 🙂) so getting my foot into one of the rare >90th %ile MGMA groups seemed unlikely.

I did have a standing job offer with the group I moonlighted for the last few years, which would've paid something near $500K, but it was 1099 with no benefits. And I have some doubts about the group's long term stability, given that another group in the area was underbid by a management company and an all-MD group suddenly found itself unemployed.

So for me, staying in was a relatively easy financial choice.

During that 13 years of payback you can always do a fellowship or even another residency or both to break up that 20 year clock.

This also factored into my decision.

At some point in the next few years, I'll spend a year as a fellow, getting paid the above ~$500K-ish equivalent salary to be a fellow.

I also transferred my GI Bill benefits to my kids. I won't know how much that will be worth until one of my kids finishes using up the benefit, but a safe estimate is over $100K. (In fairness, the 4-year commitment to transfer benefits was up before my ADSO, so I shouldn't include that in the stay-or-go math. It may apply to someone else's math though.)

 

[ProudMD]

@pgg

Can you explain how a military physician can make over $300k?????????????

That seems maddeningly high...

 

[pgg]

I agree with your train of thought.

However, I personally would rather have the cash when I am younger (40s and 50s) and my expenses are much higher (kids, college, etc) than my 60s and 70s when I have no kids and low expenses. Also even with your numbers, you still come out way ahead financially as a PROCEDURAL medical and/or surgical subspecialist by NOT entering the military.

That's a fair point.

And to be honest, the whole "get paid now to pay bills now" was a big reason I joined the Navy in the first place. We wanted to have kids right away, and the pay/benefits during school and training made it a much more comfortable, enjoyable period of life for us.


However, if just comparing retirement savings, I think it's worth additional consideration to the following -

When comparing the cash-equivalent of what the military is "vesting" in the pension during those final years on AD to the higher pay as a civilian ... if the rationale for getting out is that the higher civilian pay can equal or exceed the loss of the pension, civilian-you wouldn't have the cash on hand after all. Because the excess civilian pay, up to the amount the military is vesting in the pension, would be saved in a retirement account, not spent on your kids and their college costs.

Which itself is another wrinkle to all of this math. The military pension is essentially forced retirement savings (there's merit and demerit to that) but it's all tax-deferred savings. If you're going to exit military service and justify that financial decision by saying the higher civilian pay will allow you to save as much as the pension would've been worth, you have to
a) actually save that money, not spend it on toys or a big house or even your kids' college
b) take into account the fact that you're not likely to be able to save that much each year pre-tax

Point (b) is especially important, because in comparing my ~$500K effective Navy pay that I detailed in my previous post, $200K (the pension vesting) is being saved pre-tax (it'll be taxed when paid to me in retirement, like a traditional IRA), and I have some other untaxed pay like BAH, and I can contribute $18K/year pre-tax to TSP, so my marginal federal tax rate will probably be 28% (up to $226,850 for married filing jointly this year).

In contrast, that $500K 1099 civilian job I decided not to take would've put me into the 35% bracket (over $405,100 for MFJ) even after maxing out pre-tax retirement savings. And, that job was in California, so there goes another 10% in state taxes.


For me, getting out at the end of my ADSO and funding retirement savings just to match the military pension wouldn't have meant more cash in hand.

But it would have meant paying an extra ~17% in taxes to the government. Not later, but right now.

 

[pgg]

@pgg

Can you explain how a military physician can make over $300k?????????????

That seems maddeningly high...

Why is it maddening?

I assume you're referring to this line of my above post:

An O5 >12 to >18 under 4-year MSP in my specialty earns roughly $250-275K/year. Adding in a couple of tax benefits to being in the military (BAH, and not having to pay a 5-10% state income tax) brings that to $290-315K or so

Take the middle range of that, an O5 >14
- base pay 8053/month = $96,636
- BAS 253/month = $3,036
- BAH with dependents (at one of the big 3 Navy medcens: 2343 (Portsmouth), 3141 (San Diego), or 3078 (Bethesda) ... let's use the lowest = $28,116
- VSP 833/month = $10,000
- BCP 417/month = $5,000
- ASP $15,000
- 4-year MSP/ISP anesthesiology = $110,000

= $267,788 for Portsmouth or $277,364 for San Diego

Which is right in line with my above $250-275K estimate.

Accounting for the tax benefit ... not paying 5% Virginia income tax in Portsmouth is worth about $13K, or not paying 10% California income tax in San Diego is worth about $27K. That's where I get my rough estimates of mid-career MSP-contracted pay.


All that and free travel, too. Room and board for the trip included.

 

[ProudMD]

Why is it maddening?

I assume you're referring to this line of my above post:



Take the middle range of that, an O5 >14
- base pay 8053/month = $96,636
- BAS 253/month = $3,036
- BAH with dependents (at one of the big 3 Navy medcens: 2343 (Portsmouth), 3141 (San Diego), or 3078 (Bethesda) ... let's use the lowest = $28,116
- VSP 833/month = $10,000
- BCP 417/month = $5,000
- ASP $15,000
- 4-year MSP/ISP anesthesiology = $110,000

= $267,788 for Portsmouth or $277,364 for San Diego

Which is right in line with my above $250-275K estimate.

Accounting for the tax benefit ... not paying 5% Virginia income tax in Portsmouth is worth about $13K, or not paying 10% California income tax in San Diego is worth about $27K. That's where I get my rough estimates of mid-career MSP-contracted pay.


All that and free travel, too. Room and board for the trip included.

Thanks for the breakdown. The thing that really got me is the MSP bonus. To my understanding, you only qualify for MSP after fulfilling your ADSO, but does MSP really pay that much? So you are getting a 100k bonus on top of everything else every single year you stay in after ADSO?

If the military pay is basically on par with civilian pay after ADSO and you have a good pension waiting for you after 20 years...then why is the military having difficulty retaining doctors after their ADSO? I've read somewhere that an overwhelming majority of military physicians leave the service after their ADSO...what's the reason behind this?

 

[pgg]

Thanks for the breakdown. The thing that really got me is the MSP bonus. To my understanding, you only qualify for MSP after fulfilling your ADSO, but does MSP really pay that much? So you are getting a 100k bonus on top of everything else every single year you stay in after ADSO?

You are eligible to sign a MSP contract after 8 years of service. At that point, if you still have an ADSO for residency, med school, ROTC, or something else, you can still sign the MSP contract and collect right away, but the MSP contract will tack on time to your ADSO. And during that final few years, you'll be paying off owed time but not getting MSP pay.

All the gory details:

http://www.med.navy.mil/bumed/Special_Pay/Documents/FY14 Special Pay Plans/FY14 MC-DC Special Pay Implementation Guidance (14Nov12).docx

See page 9 for the FY2014 rates.

Second line ... just ISP for anesthesiology is $36,000. If under MSP contract, ISP increases to $50,000. The MSP payment depends on length of contract. For 2-year contracts, the MSP portion is $25,000 (total $75,000); for 3-year contracts, the MSP portion is $40,000 (total $90,000); for 4-year contracts, the MSP portion is $60,000 (total $110,000).

If the military pay is basically on par with civilian pay after ADSO and you have a good pension waiting for you after 20 years...then why is the military having difficulty retaining doctors after their ADSO? I've read somewhere that an overwhelming majority of military physicians leave the service after their ADSO...what's the reason behind this?

Well, not to derail this thread because we have plenty of "con" threads ...

It's because the military treats an awful lot of doctors like disposable cogs in a dysfunctional machine. The angry and miserable people posting on this forum aren't just fabricating their experiences. At some point, getting crapped on every day will trump a nice financial planning spreadsheet.

Skill atrophy for highly specialized people is a problem. Patient acuity and volume in the military is very low compared to the civilian world.

Deployments and having to move every few years can be hard on families, especially if the military doctor is married to another professional who has a career to establish and advance.

And, there are other things to consider. Simple things, like the fact that some specialists can expect to earn far more money on the outside, approaching or exceeding 7 figures. But also second-order things ... consider a civilian surgeon whose earning and professional stability steadily increases over a period of YEARS as he establishes a practice in a community and builds relationships with referring doctors. If that surgeon spends another 10 years in the military, he will enter civilian practice 10 years behind that practice growth curve. How do you account for that opportunity cost? Excel doesn't really have a function for it.

And every specialty is different. I'm an anesthesiologist, which means at the end of the day I'm a commodity, an ancillary service provider to the people who bring patients to the hospital. I don't have an office, I don't do clinic, I don't have employees, I don't have overhead ... that practice growth curve is far less an issue for me.

 

[pgg]

Stay in France, you cheese-eating surrender monkey.

Now now, let's be nice to our joined-yesterday pre-med guest. He's not clueless because he's French. 🙂

And at least he hasn't bumped any 2007 threads yet.

 

[Chonal Atresia]

TurtleDO2012, I agree almost exactly with this line of thought, and indeed it's how I calculated the financial difference between staying in and getting out when my educational obligation was up. However, I have two large quibbles with your assumptions and math.

First, it assumes retirement as an O6. The days when nearly everyone could count on pinning on a silver eagle if they stayed for 20 are absolutely, completely, categorically, totally OVER. Only around 50% make O5 their first time in zone these days. That's not to say you can't or won't make O6; just that most medical corps officers who retire at 20 or 21 probably won't. I think this kind of math should be done conservatively, assuming an O5 retirement grade.

Second, I think you significantly overvalue the cash value of the pension -



I don't think this is the correct way to estimate the value of a military pension, though I'd be interested in how you arrived at that number and if you're doing any kind of inflation adjustment (which I think would be wrong for this specific purpose).



I also am not prepared to buy off on the notion that the lifetime healthcare benefit is worth $500K to $1 million ... for the simple reason that I think it'll actually be worth nothing, because I believe by the time I get there, the USA will have some form of nationalized healthcare for all and EVERYONE will have Tricare- or Medicare-caliber health insurance. IOW, I don't believe I'll gain anything, health-insurance-wise, over any random hobo on the street who didn't do 20 in the military.

But to get to the math ... most simply, if you just do the math for the 30-year payout in retirement, an O6/21y pension would be high-36 base pay ($9272 + 9272 + 9721 / 3) x .525 (21y high-36 retirement multiplier) x 12 months x 30 years = $1,780,695. But that's not quite right, too simplistic.

You could estimate a cash value, including inflation adjustments, by buying the right number of TIPS to match the pension payout, then using your psychic powers to time your death perfectly and die broke. Or you could use the CDC's life expectancy tables and buy enough TIPS to take you until the day you're scheduled to die, Logan's Run style. This is a stupid way to plan for retirement 🙂 but as an estimate of a pension's cash value it has a lot of merit.

But I think the most correct way to estimate the cash value of a pension on the date of retirement from the military (which is the figure you want, when making get-out vs stay-in calculations) is the lump sum CASH cost of an inflation indexed single premium immediate annuity (SPIA), because that's what military retirement pay is: an annuity, with some kind of inflation or cost of living adjustment, that pays for the rest of your life, and then has zero value when you die.

When I did the math, a bit over a year ago using the 2013 pay tables and a 2013 online SPIA quote, these are the numbers I came up with for my projected situation. I anticipate retiring as an O5, with high-36 pay (and note that's the >16, >18, >18 lines ... remember high-36 is NOT just three times >20 pay!), and a 25-year retirement multiplier (my USUHS kicker).

$1,641,147 best estimate: A CPI-indexed SPIA for a 55-yo male paying $60,322/y ($3676/y per $100,000 premium).
$1,169,031 lower bound: A non-indexed SPIA for a 47-yo male paying $60,322/y ($516/y per $10,000 premium).
$2,050,948 upper bound: Buy TIPS, time my death perfectly, die broke. Provides an inflation-adjusted $60,322/y for 34 years.




In my case, I was eligible to get out at 12 years, so I divided the above $1.6 million by the 8 additional years needed to "vest" in the military pension, or $200,000 per year.

An O5 >12 to >18 under 4-year MSP in my specialty earns roughly $250-275K/year. Adding in a couple of tax benefits to being in the military (BAH, and not having to pay a 5-10% state income tax) brings that to $290-315K or so, plus the $200K of value each year "vests" in the pension, I estimated the value of my Navy pay during those final eight years at roughly $490-515K per year.

Plus some nebulous, very hard to estimate 'value' to the lifetime healthcare benefit for me and my wife. Which, as I noted above, may or may not really be worth anything. But it deserves some consideration.


Civilian jobs paying $500K can be had in my specialty (anesthesiology), but the outlook for them being around for the next 8 years isn't so rosy. The ones that will pay that tend to have some drawbacks ... high CRNA supervision/direction ratios, lots of call, a high hospital subsidy (dangerous to count on), high hours. I don't have any real networking connections (outside SDN 🙂) so getting my foot into one of the rare >90th %ile MGMA groups seemed unlikely.

I did have a standing job offer with the group I moonlighted for the last few years, which would've paid something near $500K, but it was 1099 with no benefits. And I have some doubts about the group's long term stability, given that another group in the area was underbid by a management company and an all-MD group suddenly found itself unemployed.

So for me, staying in was a relatively easy financial choice.




This also factored into my decision.

At some point in the next few years, I'll spend a year as a fellow, getting paid the above ~$500K-ish equivalent salary to be a fellow.

I also transferred my GI Bill benefits to my kids. I won't know how much that will be worth until one of my kids finishes using up the benefit, but a safe estimate is over $100K. (In fairness, the 4-year commitment to transfer benefits was up before my ADSO, so I shouldn't include that in the stay-or-go math. It may apply to someone else's math though.)

Well articulated and detailed post, pgg. Much more thought and time than I'm willing to go into. I left this past summer with 12 years in and nothing to show for it other than GI Bill transfer to my kids. I was hoping retirement rules would be changed to reflect a 2.5%/yr with a minimum of 10 years, but it was not to be.

My math was similar to pgg's - I estimated that I would need to make around 500k/yr in order to justify leaving the military from purely a financial perspective. Luckily, I am in a lucrative practice (35+ surgeons in a multi-specialty group) with great insurance contracts so 700k+/yr is easily attainable even with seeing only 40 patients per day in clinic. pgg did forget to mention ancillary passive income that you are not eligible for while working in the military (for ENTs this includes hearing aid sales, reading fees for CT scans, allergy shots, ownership in surgery centers, etc). Obviously, anesthesiologists are not eligible for this passive income. The 700K+ figure does not include these ancillaries so leaving was obviously an easy decision for me.

As stated in many other threads, there are a plethora of other reasons to leave the military. In the end, physicians will ALWAYS be seen as a liability to the DoD sucking money away from troops and bullets. This is the complete opposite of civilian medicine where physicians are revenue generators for hospitals and thus are treated much better (see preferential parking, pay-for-call, free meals, paid CME, doctors lounges, etc). You can only take being treated like s.. for so long.

 

[colbgw02]

pgg doing work in this thread. However, I think you are eligible to sign up for MSP before eight years if you have completed your education service obligation.

From the link you posted: "who has at least eight years of creditable service, or has completed any active duty service commitment incurred for medical education and training, and..."

I read this as a 4-year HPSP recipient who completes a 3-year residency and 4-year payback would be eligible for MSP after 7 years.

 

[pgg]

Yes, you're right. If the education ADSO is finished, you can extend with a MSP contract.

 

[Marie-Curie]

Stay in France, you cheese-eating surrender monkey.

american mentality

Now now, let's be nice to our joined-yesterday pre-med guest. He's not clueless because he's French. 🙂

And at least he hasn't bumped any 2007 threads yet.

The fact that you're working for the navy makes me think you have to have the motivation and a love of your country to bind your family life to your life military doctor, difficult as it sounds. I greet your effort but hypocritically

This is a debate that needs to be maintained.

 

[bricktamland]

But I think the most correct way to estimate the cash value of a pension on the date of retirement from the military (which is the figure you want, when making get-out vs stay-in calculations) is the lump sum CASH cost of an inflation indexed single premium immediate annuity (SPIA), because that's what military retirement pay is: an annuity, with some kind of inflation or cost of living adjustment, that pays for the rest of your life, and then has zero value when you die.

When I did the math, a bit over a year ago using the 2013 pay tables and a 2013 online SPIA quote, these are the numbers I came up with for my projected situation. I anticipate retiring as an O5, with high-36 pay (and note that's the >16, >18, >18 lines ... remember high-36 is NOT just three times >20 pay!), and a 25-year retirement multiplier (my USUHS kicker).

$1,641,147 best estimate: A CPI-indexed SPIA for a 55-yo male paying $60,322/y ($3676/y per $100,000 premium).
$1,169,031 lower bound: A non-indexed SPIA for a 47-yo male paying $60,322/y ($516/y per $10,000 premium).
$2,050,948 upper bound: Buy TIPS, time my death perfectly, die broke. Provides an inflation-adjusted $60,322/y for 34 years.




In my case, I was eligible to get out at 12 years, so I divided the above $1.6 million by the 8 additional years needed to "vest" in the military pension, or $200,000 per year.

pgg,

Thanks for posting all this information. I'll be at the 12 year crossroads shortly so this discussion is highly pertinent to my situation. Your financial analysis makes tremendous sense to me. I was wondering if you could provide some guidance on how to work up a scenario for a federal job option (i.e. VA job, GS position, etc). I'd like to see how the federal job with FERS stacks up against the military retirement when applying your methodology. In this scenario, I would be separating at 12 years, taking a federal job, and then "buying back" those 12 years and applying them towards FERS.

Another question. The $60,332/year figure that you quote, does that include your 25-year retirement multiplier for USUHS? Because I would base my calculations off the exact same situation as you (O-5 at 20 years), minus that kicker. Thus, I think my figure would be lower than the $60,332 amount you quoted. Using this website: http://militarypay.defense.gov/retirement/calc/02_highthree.html, I estimated my high-3 retirement pension in 2015 dollars is $45,358. So I would use that figure in the annuity calculation you used, right? Do you have a website or formula that I can use to calculate SPIAs? The websites I've looked at aren't super helpful, and none that I saw offered the option of CPI indexing

 

[pgg]

I was wondering if you could provide some guidance on how to work up a scenario for a federal job option (i.e. VA job, GS position, etc).

I don't know enough about how carrying credit or buying into VA/GS jobs with military years works to comment intelligently on that.

The $60,332/year figure that you quote, does that include your 25-year retirement multiplier for USUHS?

Yes. 20 years of service for eligibility so my high 36 average was calculated as (12 x O5>16) + (24 x O5>18) / 3 ... but with a 25-year multiplier (62.5%). In my figures above I used the 2013 tables, but using the 2015 pay table it would be $61,537.

For USUHS grads the time spent there is credited per this memo: http://pggweb.com/USUcredit.pdf

(I was at USUHS for 5 years. I missed large chunks of my MS1 year and joined the next MS1 class the following year, so my USUHS ADSO was 8 years not 7, and my multiplier kicker is +5 not +4.)

Because I would base my calculations off the exact same situation as you (O-5 at 20 years), minus that kicker. Thus, I think my figure would be lower than the $60,332 amount you quoted. Using this website: http://militarypay.defense.gov/retirement/calc/02_highthree.html, I estimated my high-3 retirement pension in 2015 dollars is $45,358. So I would use that figure in the annuity calculation you used, right? Do you have a website or formula that I can use to calculate SPIAs? The websites I've looked at aren't super helpful, and none that I saw offered the option of CPI indexing

For O5 @ 20 no USUHS kicker, based on the 2015 pay tables, I get (8053 x 12 + 8281 x 24) / 3 x 50% = $49,230.

I'm not sure why the .gov web site calculator puts it at $45,360. Almost is if they're using the O5>14 line.

This was the web site I used to estimate the cost of the inflation indexed SPIA was: http://www.principal.com/retirement/incomeannuity/elm/income.htm

It's not perfect. The figure I wanted was a quote for an indexed SPIA at age 47, but the youngest quote they've got is 55. (The effect would be to somewhat underestimate the value of the SPIA.)

I looked for a while for a better online quote engine that didn't require registration or communication with an agent, but couldn't find one. There may be one out there now.

 

[bricktamland]

Thanks for the link. I’ve been able to apply the CPI-indexed SPIA formula from that website to my situation. For a non-USUHS grad, retiring as an O-5 at 20 years, the annuity would be worth about $1.34M. I’d be getting out at 12 years. So over the course of 8 years in a civilian job, I would need to earn and save an extra $167,500/year (after taxes) in order to purchase an annuity that would roughly equate to the value of the military pension. Granted, that calculation is based off an annuity starting at age 55, so in my case it would be undervalued since I would be retiring at age 48. In my specialty (radiology), earning that kind of salary in the civilian sector is doable, but I might be sacrificing certain things like a desirable location and work/life balance that I could otherwise have with the Navy.

Obviously, there is much more than finances to consider when weighing the decision to stay in/get out, but it helps to have a more concrete understanding of the money aspect. Everything else, all the other daily annoyances and gripes, are indubitably valid but less quantifiable. Once I have a dollar figure in mind though, I can better figure out at what price I’ll be willing to tolerate certain grievances. As I’ve said before, most of my time in the Navy has been enjoyable, I’m just trying to decide whether it might be even more enjoyable on the outside.

I attempted to measure the value of a FERS pension in terms of the SPIA method. FERS is also based on high-3. To calculate the pension itself, the high-3 number is then multiplied by 1.1% (as long as you have 20 years of service and wait to retire at age 62, otherwise it’s a 1.0% multiplier) and then it is again multiplied by the number of years of service. So if I buy in my 12 years, and then work 8 more at a VA for instance, I would have a total of 20 years with the Feds. I’m not totally sure what my high-3 would be for my specialty, but I estimate around $300K. Thus, my pension would be $66K starting at age 62. Using that same CPI-indexed SPIA formula, that pension would be worth $1.55M (based on age 60) or $1.32M (based on age 65).

However, those figures do not compare directly with the military pension because, as stated before, the military pension is undervalued since it is calculated off age 55 (the lowest age available in the table from the website). Thus, I might need to extrapolate from their data in order to get a more accurate comparison. This will take some work, but I think it’s worthwhile to try to place a concrete number on the value of a pension.

 

[apeman4200]

great info for everyone to consider

 

[pgg]

As long as we're getting off into the weeds here, I do want to make one more comment about that SPIA quote page.

While it is true that the SPIA quoted for a 55 yo would pay a higher benefit per unit premium than one for a 47 yo (if the company sold one), and thereby gives a lower estimate of the value of the pension, I don't think it's that big a deal for a couple reasons.

One, the price of the SPIA includes profit for the company selling it, whereas the gov cost doesn't require profit or insurance swaps or even any kind of solvency margin.

Two, while SPIAs may have a place in a person's retirement planning, especially as age advances and security needs start to outweigh growth needs, annuities really are expensive, poorly performing investments. For a person who expects to live another 30 or 40 years, better returns can almost certainly be had, safely, with other investments. So the amount of money a get-out-before-retirement person would need to invest (at low risk) to match the .mil pension would in reality be somewhat less than the cost of the (almost zero risk) SPIA.

It's really hard to make rigorous apples to apples comparisons. This is all very fuzzy math with assumptions hidden behind assumptions.

 

[TurtleDO2012]

I was using the calculator from military pay to estimate the value of the total retirement package.

http://militarypay.defense.gov/retirement/calc/02_highthree.html

Allows you to enter estimated year of retirement, estimated pay raise but lowest value is 2% only, play with inflation, and tax rate. Breaks down a monthly and yearly. If money is left to fund it as indicated. http://news.usni.org/2013/07/10/opinion-military-pay-and-benefits-unsustainable

Another interesting article- https://www.cna.org/sites/default/files/news/2010/Comparing Military and Civilian Compensation Packages D0016569.A4.pdf

Greatly appreciate pgg getting into the details.

 

[pgg]

You can certainly count on the .mil and .gov hosted calculators to be optimistic.

They're not lying, but they make certain assumptions. The sites exist as recruitment and retention tools. A good data point, but caveat emptor.

 

[BigNavyPedsGuy]

but I might be sacrificing certain things like a desirable location and work/life balance that I could otherwise have with the Navy.

You completely lost me with this line. My #1 reason for getting out was the terrible work/life balance in the Navy. I texted a friend of mine who's still stuck in the Navy today. My partner is on family leave after an adoption. I'm working extra for a bit, but I have a finite number of days so it'll all go around and come around. And if I didn't get the time off, I would get paid extra for any call above my contract, etc. She has a partner going on maternity leave so she's on Q2 call for 6 weeks. NO make up time, no reward for that hard work. Nothing.

There is no FTE deduction in the Navy. There is no balance. It's work what we tell you or you'll go to jail for desertion.

There is no dollar amount to substitute for me being able to watch my kids grow up.

 

[bricktamland]

You completely lost me with this line. My #1 reason for getting out was the terrible work/life balance in the Navy. I texted a friend of mine who's still stuck in the Navy today. My partner is on family leave after an adoption. I'm working extra for a bit, but I have a finite number of days so it'll all go around and come around. And if I didn't get the time off, I would get paid extra for any call above my contract, etc. She has a partner going on maternity leave so she's on Q2 call for 6 weeks. NO make up time, no reward for that hard work. Nothing.

There is no FTE deduction in the Navy. There is no balance. It's work what we tell you or you'll go to jail for desertion.

There is no dollar amount to substitute for me being able to watch my kids grow up.

In my experience, one's individual circumstances in the Navy can be quite variable. For instance, at my current duty station, my work/life balance is actually very good. Much of this is due to the fact that our specialty is currently overmanned, and we have a good ratio of radiologists for the relative FTE. It wasn't too long ago though, that the opposite was true. I've heard numerous tales from our Corpsmen who worked with the radiologists of yore at my current hospital, when it was undermanned. Those radiologists were invariably totally overworked, stressed out, bitter, and angry. Reflecting on my own time in the Navy, the same can be said of my experience as a GMO. I had a miserable time and feel like the Navy really threw me to the wolves. In contrast, some of the people I went to residency with had an amazing time as flight surgeons in places like Hawaii, spending their work-day afternoons on fishing boats. On a similar note, several of the staff at my residency are nearing retirement and they've never deployed and virtually never moved. Others have moved and deployed numerous times (and for some that's a positive). But it's kind of disturbing how variable it is.

Aside from my stint as a GMO, the remainder of my time in the Navy has been pretty decent. All that said, I'm well aware that 8 more years in the Navy is not a predictable experience. And that definitely concerns me. I'm tired of moving and I'm not excited about deploying--especially now that I'm married with kids. Who knows what the atmosphere will be like with each succeeding CO? They change every two years. How ridiculous is that?

Ironically, the stability of the military is also one of the more attractive features; mainly the reliable pay and benefits. I wish the stay/leave decision was more straightforward for me like seems to be for others. I'd estimate I'm about 70/30 in favor of leaving right now.

 

[j4pac]

^Me at this thread

 

[colbgw02]

Thanks for the link. I’ve been able to apply the CPI-indexed SPIA formula from that website to my situation. For a non-USUHS grad, retiring as an O-5 at 20 years, the annuity would be worth about $1.34M. I’d be getting out at 12 years. So over the course of 8 years in a civilian job, I would need to earn and save an extra $167,500/year (after taxes) in order to purchase an annuity that would roughly equate to the value of the military pension. Granted, that calculation is based off an annuity starting at age 55, so in my case it would be undervalued since I would be retiring at age 48. In my specialty (radiology), earning that kind of salary in the civilian sector is doable, but I might be sacrificing certain things like a desirable location and work/life balance that I could otherwise have with the Navy.

One thing to remember is that you don't actually have to save every dollar of that $1.34MM because the money that you save in a civilian job will gain value. Keeping the math simple and using the rule of 72, let's say you save $100K in the first year with a 10% rate of return. That will be worth more than $200K at the end of the 8-year window. Obviously, the actual math is much more complicated, as I'm pretty sure it uses some calculus that my brain dumped over a decade ago, and 10% is an aggressive number, but I would guess that the actual savings rate would probably be closer to $125K/annum. Regardless, I think pgg's overall point remains that it is exceedingly difficult to save enough over the window in question in order to match the military pension's value, mostly due to lifestyle creep and tax considerations.

You completely lost me with this line. My #1 reason for getting out was the terrible work/life balance in the Navy. I texted a friend of mine who's still stuck in the Navy today. My partner is on family leave after an adoption. I'm working extra for a bit, but I have a finite number of days so it'll all go around and come around. And if I didn't get the time off, I would get paid extra for any call above my contract, etc. She has a partner going on maternity leave so she's on Q2 call for 6 weeks. NO make up time, no reward for that hard work. Nothing.
There is no FTE deduction in the Navy. There is no balance. It's work what we tell you or you'll go to jail for desertion.
There is no dollar amount to substitute for me being able to watch my kids grow up.

I think this is reflective of the respective specialties and their job markets. Civilian radiology isn't a lifestyle specialty any longer, plus the job market stinks right now. It's entirely possible, even likely, that a separating radiologist would have to sacrifice either quality (internal nighthawk, e.g.), location, or both in order to find a job. The Navy offers a slower pace and, in this instance, a great location, which aren't readily available in combination in the civilian world. The problem is, as mentioned, variance and predictability. Those attributes are tremendously devalued by spending time away from family while deployed or subject to change when someone decides to cut the number of billets at a base. In any case, as things are right now, it's not difficult for me to see why staying in the military would be a lifestyle decision.

 

[bricktamland]

This thread in a nutshell:

Don't sign up for the money. But if you do, perhaps you'll stay for the money.

 

[ProudMD]

Personally, I find 120-150k a year as a military attending after residency more than adequate, especially considering $0 debt, USUHS salary, and substantially higher residency pay. I really don't care about all the retirement numbers at the moment, haha.

 

[Chonal Atresia]

Personally, I find 120-150k a year as a military attending after residency more than adequate, especially considering $0 debt, USUHS salary, and substantially higher residency pay. I really don't care about all the retirement numbers at the moment, haha.

More than adequate?

You may (and will) sing a different tune when you see your colleagues making 4x what you make. If you like socialism, than military medicine is the perfect place for you. No monetary reward for hard work, high-grade performance or productivity. Primary care makes close to the same as specialists - definitely not a free market.

Enjoy!

 

[colbgw02]

Personally, I find 120-150k a year as a military attending after residency more than adequate, especially considering $0 debt, USUHS salary, and substantially higher residency pay. I really don't care about all the retirement numbers at the moment, haha.

...said everyone before medical school and no one after residency.

 

[ProudMD]

More than adequate?

You may (and will) sing a different tune when you see your colleagues making 4x what you make. If you like socialism, than military medicine is the perfect place for you. No monetary reward for hard work, high-grade performance or productivity. Primary care makes close to the same as specialists - definitely not a free market.

Enjoy!

I definitely know that the civilian sector pays a lot more, but do most (or even many) physicians make 500-600k a year? That's how much they'll have to make to be 4x as much as a military salary. Last time I checked, the average salary for physicians as a whole group is around 180-250k a year. Of course there are the star docs who pull in 500k+, but are they anywhere near the majority? And given the way healthcare is going in this country, how certain are we that specialist salaries will remain high into the future?

And I don't necessarily compare myself to civilian doctors. I compare my income to the national average, and 130k or so a year of starting salary (which will increase dramatically either through MSP/retirement or leaving after ADSO) still places me at a very privileged position compared to the rest of society. And for that I am grateful and satisfied.

 

[Chonal Atresia]

I definitely know that the civilian sector pays a lot more, but do most (or even many) physicians make 500-600k a year? That's how much they'll have to make to be 4x as much as a military salary. Last time I checked, the average salary for physicians as a whole group is around 180-250k a year. Of course there are the star docs who pull in 500k+, but are they anywhere near the majority? And given the way healthcare is going in this country, how certain are we that specialist salaries will remain high into the future?

And I don't necessarily compare myself to civilian doctors. I compare my income to the national average, and 130k or so a year of starting salary (which will increase dramatically either through MSP/retirement or leaving after ADSO) still places me at a very privileged position compared to the rest of society. And for that I am grateful and satisfied.

Most specialists make well over 200K and many make more than 500K. If you are talking primary care, than 200-250K is about right.

You will be in school until at least age 29 when most of your buddies will begin making money at 22. That's 7 years you'll be treading water. Money is not everything, but it is easy to take your stance when you are single with no kids and haven't gone through the gauntlet that is medical school and residency.

I would bet money (maybe your 130k salary) that in 7-9 years you won't feel the same way.

 

[ProudMD]

Most specialists make well over 200K and many make more than 500K. If you are talking primary care, than 200-250K is about right.

You will be in school until at least age 29 when most of your buddies will begin making money at 22. That's 7 years you'll be treading water. Money is not everything, but it is easy to take your stance when you are single with no kids and haven't gone through the gauntlet that is medical school and residency.

I would bet money (maybe your 130k salary) that in 7-9 years you won't feel the same way.

I think you are probably right. But it is worth emphasizing that I'll be make a good salary throughout USUHS (instead of carrying 300k worth of debt) and over 80k a year during residency (so just like most of my buddies, I'll be making a good income - probably more than the average college grad - throughout my education and training). To me, that really gets rid of all the financial stress that I would otherwise have towards a medical education.

 

[haujun]

I think you are probably right. But it is worth emphasizing that I'll be make a good salary throughout USUHS (instead of carrying 300k worth of debt) and over 80k a year during residency (so just like most of my buddies, I'll be making a good income - probably more than the average college grad - throughout my education and training). To me, that really gets rid of all the financial stress that I would otherwise have towards a medical education.

Definitely USUHS students are most happy medical students in the U.S...getting paid to attend the medical school. It just sounds too great to be true. But I met many USUHS colleagues who hated a long obligation and regret their decision in joining the military many many years ago when their main concern was about finding the way to pay for medical school. I guess priorities have changed over the years and you can read about some of them in this forum.

Fortunately I was lucky and I had a good experience..well mostly. But you are right. If you are satisfied with military lifestyle and generally satisfied about getting paid according to rank and years of service regardless of your productivity then you are going to be ok.

 

[ProudMD]

Definitely USUHS students are most happy medical students in the U.S...getting paid to attend the medical school. It just sounds too great to be true. But I met many USUHS colleagues who hated a long obligation and regret their decision in joining the military many many years ago when their main concern was about finding the way to pay for medical school. I guess priorities have changed over the years and you can read about some of them in this forum.

Fortunately I was lucky and I had a good experience..well mostly. But you are right. If you are satisfied with military lifestyle and generally satisfied about getting paid according to rank and years of service regardless of your productivity then you are going to be ok.

Yeah I've definitely heard about that one!

USUHS pays us over $5000 a month (and 40% of that is non-taxable). I did some calculations and if I live reasonably frugally during the four years of medical school, I can save close to 100k by the time I graduate! That money can then be used for retirement, investment, downpayment for a home, etc.

I think the good thing about USUHS is that it completely eliminates the need to worry about anything financially related to a medical education and eventually profession. Without this debilitating burden, I can focus all my energies towards learning/loving medicine and serving as an officer. I also don't have to feel compelled to pursue specialties I don't like just so I can make enough money to pay off $300k in loans.

 

[Cooperd0g]

A lot of USUHS students squander their financial opportunity though. Many waste money buying new cars, eating out all the time, etc. If you start putting a lot in your TSP and start a Roth IRA if you can max the TSP then you would really be on target for a good retirement regardless of if you stuck around for 20 years or not.

 

[j4pac]

A lot of USUHS students squander their financial opportunity though. Many waste money buying new cars, eating out all the time, etc. If you start putting a lot in your TSP and start a Roth IRA if you can max the TSP then you would really be on target for a good retirement regardless of if you stuck around for 20 years or not.

Very true. When I was at Bethesda during internship it was pretty easy to see which of the interns were from USUHS when we arrived for our indoc PRT. If you drove a Honda/Toyota/Ford/Chevy you were HPSP...if you drove a BMW/Mercedes you were USUHS.

 

[jabreal00]

Money is not the issue with the military. It's the variables that one is not in control over; moves to terrible locations, low acuity resulting in skill atrophy, heavy administrative soldier burden, deployments (multiple), being tasked primarily administrative jobs (brigade/flight/division surgeon), lack of funding for CME conferences, etc. If I made $150-180K as a 04/05 military physician without all the other intangibles (uncontrollable) I mentioned then I'd be doing 20+ years despite the fact that I am in a high paying specialty. I have no loans. My wife is also a physician so we are plenty comfortable. However I am out once my ADSO is up. Multiple deployments, crap locations, geographic separation from wife, multiple PCS moves have just taken a toll. I hate the perpetual feeling like the hammer is about to drop any minute with some bad news (deployment, unwanted PCS move, military administrative tasking (brigade surgeon etc).

 

[pgg]

Personally, I find 120-150k a year as a military attending after residency more than adequate, especially considering $0 debt, USUHS salary, and substantially higher residency pay. I really don't care about all the retirement numbers at the moment, haha.

When comparing and anticipating future pay to society's average, try to keep a few things in mind.

- we are and will always be blessed with steady employment and a living wage; it's good to keep some perspective and humility, something that is occasionally lost in debates about $300K vs $500K compensation packages

- physicians aren't working 40 hour weeks with hour lunches, no weekends, no call ... don't compare your pay to a laborer or cubicle drone's

- physicians start earning much later in life than everyone else

- nice stuff costs money, but it's not just BMWs that fall in the "nice stuff" category; it doesn't make you greedy to want to be able to send your daughter to gymnastics clinic or put her through college so she can start her life debt free

- physicians assume tremendous risk, and it's not just stress from the difficult work we do; risk is not just a word, risk shows up, risk hurts us all at some point; it doesn't make physicians evil to expect higher compensation for difficult, risky work that 99% of the population can't or won't do

- be wary of making declarations of how willing you are to sell yourself at a given rate before you've paid the price of admission in time, money, tears, and pain and stared down the result of some of that risk


I don't want to stomp on any pre-med's altruism and willingness to sacrifice. These are great things. Just ... don't be so eager to sell yourself so cheap, so far in advance. You're going to earn every bit of whatever you eventually get.

 

[ProwlerturnGas]

Just as an aside, I was unpacking some stuff and found a tax return from my first tour as a flight surgeon. I make exactly 7 times now what I made then.