On The Question of: Shall the Debt Be Repayed?

[YCAGA]

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More recent data disagrees with you (aside from Luxembourg).
Luxembourg 352/278
US 350/242
Belgium 331/138
Germany 222/214
Canada 249/158
Switzerland 228/172
Netherlands 200/137
Australia 210/104

I can tell you that that data is not accurate for Switzerland because that is the data I am most familiar with and the true data is the quite robust due to a comprehensive review their federal government did in 2014. That website says their data is up to date as of May 2020, but the actual median salary for all physicians in Switzerland was $282k/yr USD in 2014 which adjusted for inflation is $313k USD. But that website is claiming that Swiss specialists earn $228k/yr?? That is off by like 40%…and I wouldn’t be surprised if the other countries are similarly messed up. Just “primary care”, which doesn’t correlate perfectly with the Swiss speciality of Allgemeine Innere Medizin, but is close enough, earned $262k/yr in 2020 dollars but that site is claiming $172k/yr. No idea how they got that number because only 3 specialities out of the 35+ in Switzerland had an average salary under $200k in 2014, let alone 2020.

Thank you for linking that because it further proves my point that most of the info online in English about European physician salaries is complete junk. I would not be surprised if they used 2014 data for Switzerland and 2020 data for the US without adjusting for inflation, because recent data in English is much easier to find for the US.

 

[Chemist0157]

Australia is not comparable. One US dollar is worth currently 1.3 Australian dollars, so while the salaries in dollars may be roughly equivalent that means that we're actually making 30% more than they are. Plus, that assumes equal cost of living which for the vast majority of the US it is not. Let's also not forget their significantly higher income tax rate especially at higher income levels.

You can go ahead and throw out Luxembourg because that is a blindingly small, quite wealthy country. Same with Switzerland.

I saw a source that showed a couple of countries that do a little better with subspecialty. Think they were Australia and...the Netherlands? So I typed what I typed. Think it's similar to the chart @dpmd listed, but this one was from 2009.

But yeah, I'm not about to hop a plane and move somewhere else. Points about loans or residency don't mean much at this level.

We like to complain about how hard medicine can be, but at least at the attending level, I think a lot of us have pretty sweet gigs. I'm definitely not killing myself to do well.

 

[Chemist0157]

I never said you would make the same in Canada or any of these countries. Just that they are close to US compensation, especially when you adjust for other factors. I guess if you don’t place a monetary value on a better lifestyle and working conditions then the difference in pay seems larger.

Also my original reply to bring up other countries was that their doctors still make 6 figures since someone implied they didn’t, and then disagreeing when someone said that American doctors might “quite a bit, QUITE a bit” more than our peer countries. You guys are losing the context, which is fine, this thread has like 4 different topics going on at once. I have even said that American doctors on average win in terms of salary. My point is that they don’t win by as much as that Medscape survey makes it seem, due to a ton of reasons.

It's not particularly close though, and I have a good lifestyle and working conditions here. With the better pay. Yeah, it's not all rainbows, and US doctors can work hard for sure, but it's not a sweatshop by any means. I'm not sure where you're getting this notion that attendings are just dying from being overworked universally. The survey I linked (that you did not like) showed we have better job satisfaction that the other countries listed. There's something to that.

I think we would all do well if you provided your sources. All I have seen is other posters providing sources that express US doctors are doing pretty well and you not having much trust in the sources. Provide your own then. It's okay if it's in a foreign language. I think we can manage to read the numbers and translate "general practitioner," "subspecialist," etc because I am genuinely curious.

 

[YCAGA]

It's not particularly close though, and I have a good lifestyle and working conditions here. With the better pay. Yeah, it's not all rainbows, and US doctors can work hard for sure, but it's not a sweatshop by any means. I'm not sure where you're getting this notion that attendings are just dying from being overworked universally. The survey I linked (that you did not like) showed we have better job satisfaction that the other countries listed. There's something to that.

I think we would all do well if you provided your sources. All I have seen is other posters providing sources that express US doctors are doing pretty well and you not having much trust in the sources. Provide your own then. It's okay if it's in a foreign language. I think we can manage to read the numbers and translate "general practitioner," "subspecialist," etc because I am genuinely curious.

This is the Swiss source. Let me know if you have any questions.

https://www.bag.admin.ch/dam/bag/de/dokumente/berufe-gesundheitswesen/medizinalberufe/statistiken/med/bericht-buero-bass-aerzteeinkommen-2009-2014.pdf.download.pdf/bericht-buero-bass-aerzteeinkommen-2009-2014.pdf

German source for publicly employed physicians but this is hard to understand even with a translator because you need to understand their training system and tax code basics.

Öffentlicher-Dienst.Info - TV-Aerzte

TV-Ärzte

oeffentlicher-dienst.info

This one is for Germany too and should be more accessible with just Google translate.

Arzt Gehalt 2025 - Wie viel verdienen Ärzte?

Arzt Gehalt: was verdient ein Arzt in der Klinik oder eigenen Praxis? Welche Fachrichtung hat das höchste Arztgehalt?

www.praktischarzt.de

Here is one for Dutch but this is kinda confusing because of their ANOIS va AOIS system and doesn’t give a picture for private practice.

Wat ga je verdienen als je arts bent?

Het inkomen van dokters is een veelbesproken onderwerp. In de media wordt soms schande gesproken over de jaarsalarissen van medisch specialisten, terwijl sommige artsen zelf hun salaris niet al te hoog vinden. Wat verdient een arts eigenlijk, en waar hangt dat vanaf?

www.medischcontact.nl

Another huge thing to consider is that these numbers don’t include overtime for public hospitals employees, which can add up quickly and tracked even for residents. Not unusual for residents in Switzerland to approach or clear $100k USD for example. Now, they still deal with grumpy old attendings even in Europe, so I know for a fact that not all German residency programs actually pay out their overtime as they should…due to some creative bookkeeping that would make neurosurgery residency hour logs jealous.

DeepL is the best machine translation for Spanish, German and French btw. Not sure how it is for Dutch but seems decent on the English end lol. I would recommend DeepL unless you need to use Google translate for awebsite which DeepL doesn’t support.

I can provide more resources for different countries when I am not on my phone if you have any specific questions.

 

[dpmd]

These are numbers adjusted for purchasing power rather than just raw numbers which I suspect is the reason for the discrepancy. Student loans for any practicing doctor are not crippling because of the numerous payment plan options. There are also a variety of ways to decrease the amount of loans one ends up taking out. We don't need to change the whole system because some people make bad financial decisions.

 

[YCAGA]

These are numbers adjusted for purchasing power rather than just raw numbers which I suspect is the reason for the discrepancy. Student loans for any practicing doctor are not crippling because of the numerous payment plan options. There are also a variety of ways to decrease the amount of loans one ends up taking out. We don't need to change the whole system because some people make bad financial decisions.

I definitely agree student loans aren’t crippling for matched doctors, unless you start stringing multiple bad financial decisions together, but at a certain point, the best system in the world can’t save you from yourself. Going unmatched for multiple years is so rare for US MD/DO’s that I don’t think we should worry about overhauling the student loan process because of unmatched students.

Adjusting for PPP could explain some of discrepancy, but not all of it. And earning a lot in a high cost of living country like Switzerland still has to be looked at in terms of domestic PPP but also nominal USD terms. Many things aren’t affected by PPP like cars, international vacations, technology, etc. So making “the same” in terms of PPP due to high COL but making more nominally ends up being significant. Or another way to look at it is that I would rather live somewhere expensive and save 20% of my $120k paycheck than $80k and save 20% of my paycheck. Also, unlike US cities and physician pay, the more expensive European countries normally pay more, whereas in the US, the more expensive cities normally pay physicians LESS, in terms of PPP and nominal.

 

[NotAProgDirector]

So, I wholeheartedly agree with you, but how can the US government hold a foreign school responsible for a US citizen taking out a bad loan? Like, if Uncle Sam comes asking AUA for his money back and AUA says "no," what then?

The thread has moved on, but...

In that case, they would no longer qualify for US student loans. Problem solved.

 

[YCAGA]

The thread has moved on, but...

In that case, they would no longer qualify for US student loans. Problem solved.

Exactly. The list of international medical schools is actually pretty short and the feds do stop giving loans to ultra predatory schools…not that staying on the list makes the school a beacon of academic success stories.

 

[Matthew9Thirtyfive]

Exactly. The list of international medical schools is actually pretty short and the feds do stop giving loans to ultra predatory schools…not that staying on the list makes the school a beacon of academic success stories.

It’s absurd that you can get federal student loans to go to a Carib school with a <50% success rate.

 

[YCAGA]

It’s absurd that you can get federal student loans to go to a Carib school with a <50% success rate.

What if I promised you that I will work hard in medical school and be in 40-50% that do match. If there is a will, there is a way, you negative Nancy!!! /s

But yeah it’s pretty crazy. At least with the European, Israeli, and Australian schools approved for fed loans, you at least have a chance of staying in those countries to practice…not too many residency spots in Grenada, nor do they need 1,000 new doctors every year.

 

[calivianya]

Uh…there is a huge practical side to this that you are complete ignoring. Physical labor is very difficult to do into your 50s, let alone your 60s. And you need to work that long to save for retirement if you are making mid to high 5-figures, which is how much those jobs make normally. Yes I know everyone’s second cousin on SDN and Reddit is a plumber who makes $300k at age 35 but, on average, physical trades are making $50-70k after completing training. You can make that much with a “useless” major bachelor’s degree in your first job at 22 years old.

Also for every person like your SO that dropped out in 10th grade and never got a GED, there are at least a dozen people with that same story that will never make more than an RN and have a fraction of the job security. These anecdotes for trade jobs are so silly. I can give an anecdote about an art history major who started their own business and makes $500k/yr, and people would rightfully say that example is hardly representative. But for some reason people think anecdotes are acceptable when pushing trades jobs and averages are acceptable when talking about “useless majors.” Makes no sense.

I’ll definitely give you the practicality.

I’ll also leave anecdotes out - per recent US census data, 40%+ of recent college grads are working at jobs that only require a high school diploma, and one third of people with college degrees overall are working jobs that only require high school diplomas. (Source)

Going to get a college degree means you have somewhere between a 60-66% chance of getting a job that needs a college degree per the census, and those percentages are going to vary wildly by what field your degree is in. An older study back in 2012 (population representative, using a data set with around 2.6 million people) found that history majors only have a 2.7% chance of working in history, and are only in jobs that require a college degree 59.8% of the time. For studio art majors, the chance of getting a job that requires a bachelor’s degree is only 44%, but at least around 20% of them work in art. (Source)

Wish I could find the trade school data for comparison, but I haven’t been able to. Either way, I’m not demonizing college altogether, but rather pointing out that college is only useful when you realize it’s just another tool that needs to be used appropriately. Too many people seem to think it’s a guarantee that you’re going to find a job (in your field even) and do well enough to retire, and they take out an awful lot of debt based on this very not-data-supported belief.

We’ve gone way off the original topic here. I’d be happy to continue this conversation via PM if you want to so I don’t keep clogging up this thread.

 

[Goro]

I’ll definitely give you the practicality - one of the main reasons I wanted to leave nursing was the physical labor issue. Had way too many coworkers with chronic pain who’d had repeat back surgeries to want that for myself.

I’ll also leave anecdotes out - per recent US census data, 40%+ of recent college grads are working at jobs that only require a high school diploma, and one third of people with college degrees overall are working jobs that only require high school diplomas. (Source)

Going to get a college degree means you have somewhere between a 60-66% chance of getting a job that needs a college degree per the census, and those percentages are going to vary wildly by what field your degree is in. An older study back in 2012 (population representative, using a data set with around 2.6 million people) found that history majors only have a 2.7% chance of working in history, and are only in jobs that require a college degree 59.8% of the time. For studio art majors, the chance of getting a job that requires a bachelor’s degree is only 44%, but at least around 20% of them work in art. (Source)

Wish I could find the trade school data for comparison, but I haven’t been able to. Either way, I’m not demonizing college altogether, but rather pointing out that college is only useful when you realize it’s just another tool that needs to be used appropriately. Too many people seem to think it’s a guarantee that you’re going to find a job (in your field even) and do well enough to retire, and they take out an awful lot of debt based on this very not-data-supported belief.

We’ve gone way off the original topic here. I’d be happy to continue this conversation via PM if you want to so I don’t keep clogging up this thread.

A former president of Yale once said, "college has ruined many a good truck driver."

 

[YCAGA]

I’ll definitely give you the practicality - one of the main reasons I wanted to leave nursing was the physical labor issue. Had way too many coworkers with chronic pain who’d had repeat back surgeries to want that for myself.

I’ll also leave anecdotes out - per recent US census data, 40%+ of recent college grads are working at jobs that only require a high school diploma, and one third of people with college degrees overall are working jobs that only require high school diplomas. (Source)

Going to get a college degree means you have somewhere between a 60-66% chance of getting a job that needs a college degree per the census, and those percentages are going to vary wildly by what field your degree is in. An older study back in 2012 (population representative, using a data set with around 2.6 million people) found that history majors only have a 2.7% chance of working in history, and are only in jobs that require a college degree 59.8% of the time. For studio art majors, the chance of getting a job that requires a bachelor’s degree is only 44%, but at least around 20% of them work in art. (Source)

Wish I could find the trade school data for comparison, but I haven’t been able to. Either way, I’m not demonizing college altogether, but rather pointing out that college is only useful when you realize it’s just another tool that needs to be used appropriately. Too many people seem to think it’s a guarantee that you’re going to find a job (in your field even) and do well enough to retire, and they take out an awful lot of debt based on this very not-data-supported belief.

We’ve gone way off the original topic here. I’d be happy to continue this conversation via PM if you want to so I don’t keep clogging up this thread.

Great information and that definitely shapes my opinion differently. Thanks for sharing those links. Also another example of there being a Fed white paper on what seems like everything lol