net salary, a comparison

[Parsifal]

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I'm an Italian physician and I'm applying for the usmle complex. Before taking some tough decisions I'd like to have a somehow realistic comparison between Italy and US regarding salary.
In Italy a physician (regardless of his specialty) works 38 hours per week and earns about 31,200$ net fresh out of residency and 60,000$ net with 7 years of experience. Medical assistence, social security and retirement policy are provided by the state. Education was free so I won't have to pay back loans.
Say I become a general surgeon and earn 250,000$, which should be a median salary. What is the net takehome after taxes (malpractice insurance, medicare, retirement policy and so on)? I heard I should grossly consider 50%. I know there are a million variables to take into account, but I only need to understand if it is worth moving to another country.
Thanks.

Andrea

 

[TysonCook]

Hello,
There are a lot of threads on this (do a search). You should probably plan on earning more than $250k, but also realize that you will be working quite a bit more than 38hours a week.

50% in taxes is about correct (including state taxes).

A better way to do the math is look at how much you are going to be paid per hour, instead of salary. If you get paid $500,000, but work 85 hours a week, it may not be worth it.

 

[soulofmpatel]

As a rough estimate, an American general surgeon works 60 hours per week and makes $200,000/year (including expenses and malpractice but not including taxes) Federal tax/ state tax/social security might knock off 45% combined (the max federal tax bracket is 35% for income over $373,000). A modest house in a big city here could easily cost $500,000, and people often pay $2,000-3,000 mortgage payments.

 

[RabbMD]

As a rough estimate, an American general surgeon works 60 hours per week and makes $200,000/year (including expenses and malpractice but not including taxes) Federal tax/ state tax/social security might knock off 45% combined (the max federal tax bracket is 35% for income over $373,000). A modest house in a big city here could easily cost $500,000, and people often pay $2,000-3,000 mortgage payments.

Just wait till you learn about marginal tax rates and AMT. There is in fact a 35% marginal bracket that starts all the way down to the low 200Ks married filed jointly if you are hit by AMT because of the combination of AMT exemption phaseouts and AMT itself. Additionally, since AMT ignores state taxes you get the full force of the entire state marginal income tax rate as well. My taxable income is in the low 200s and I pay a true 42.8% marginal tax rate before medicare payroll tax. Before my wife quit working she got hit with a 42.8% + 1.45% + 6.2% = 50.45% marginal tax rate for her $20/hour job.

Nice huh. I guess the good news is when they remove the bush tax breaks in 2012 it will not hit me much if at all 🙂.