Residency is done, Some thoughts

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I'm not complaining, just pointing out that in some places, the cost of living can be higher.

I lived in both places. In my case, that's where the jobs were. It worked out ok for me, but going where the cost of living is lower, and salaries higher, would be a wiser choice for most.

it's like saying I can't afford transportation and then posting a pic of veyron

In Silicon Valley, that would be a Tesla.

Dear god, you might have to *gasp* get a condo or not live in Silicon Valley!

Never!


( Cover art title: "A View of the World")

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you gotta truly be a money nerd of some sorts if you want to become largely successful with money some day. and i'm talking more than having a good emergency fund in your bank and retiring decently etc. you kind of have to be sort of weird or you're going to end up like most of society and just be alright or worse.
 
OP, I completely sympathize with your point of view. I have experienced similar feelings after realizing how much of my life was spent on call in the hospital.
I think it's a great post, and should be read by anyone contemplating medicine. However, I disagree about the money. It's true that the debt can be formidable, and if you will have a large debt total and will be going into a lower paid specialty, the math may not work out in your favor.

That said, many of us have lost perspective on salaries. The average US income is about 52k. Most Americans would consider an income of 100k to be rich. 200k , unimaginable. If you were a computer programmer AND you founded Facebook or Twitter, you would have more money, but you didn't do that. Neither did 99% of programmers, who work very long hours for a lot less money than you will earn.

They highest " guaranteed " income that I'm aware of is being a physician. I'm not saying it's worth all the misery you went through, but the money is actually pretty good. Investment banking jobs and highly compensated corporate positions do pay more, but those jobs are few and far between, they often work longer hours than doctors, and most who try for those jobs don't get them.

If you are in a highly compensated specialty, as I believe you are, and you're careful with your money, then you can easily achieve a net worth in the low to middle 8 figures in your lifetime. That's rich. You are probably comparing yourself to billionaires. You will not become a billionaire as a physician. If you want that kind of money, become a physician entrerpreneur.

Note: You can either accumulate a high net worth, OR have a lot of toys: Lamborghini, a plane, a big boat, a vacation home. As a physician, you won't be able to have both. Decide which one you want, and proceed from there. If you want both, you need to get lucky or do what the really rich people did: start a successful company, or marry someone who did.

Spot on, sir.
 
The only way to get rich in socialist America is to have friends in the current regime. Everyone knows that.
 
Yes, the wet dream of inheriting billions of old money sounds great, but most people achieve financial success through what you're saying. The average person who works hard, has a well paying job and has a very high net worth, does it by saving and investing. There aren't really any 'jobs' now that allow you to become financially independent...you have to start a (highly successful and probably not feasible) company with a software-like markup, or win the lottery for that to happen. Or be given a large inheritance. All are very unlikely.

I had a work acquaintance who made himself thru selling modular helicopter storage containers. He had a $3 million house with a private runway to his garage but he had these bizarre idiosyncracies about money, which allowed him to be so wealthy. For example, he never bought alcohol because it was 'too expensive' so once a week he'd drive to this hotel where they served free glasses of $5 bottles of wine. He also never bought a new car. Everyone I've met who has had a decent net worth has been singularly fixated on growing that number.
This, right here. Most "rich" people I know don't drive insane cars and live lavish lifestyles. They are extremely frugal, which is what got them to their position in the first place. Most Americans don't have the stomach to do what it takes to get there. They want everything now. That's why they're paying $500+/month for cars they really can't afford and not even setting up a budget to abide by each month. They're too busy keeping up with the Joneses and looking for the next thing to buy. Wealth is built, not bought. And doctors are certainly not immune to the "keeping up with the Joneses" mentality.
 
Medicine in general is like slavery. Work >100 hours a week for a system that doesn't care about you.pick your specialty wisely. Anaesthetics is plush. Renal is by far the hardest and mentally draining, everyone of your patients is at death's door
 
Medicine in general is like slavery. Work >100 hours a week for a system that doesn't care about you.pick your specialty wisely. Anaesthetics is plush. Renal is by far the hardest and mentally draining, everyone of your patients is at death's door
 
OP you wrote a great post. I really appreciate your insights. I am sincerely curious what career is a viable alternative to becoming a physician, that may require less investment of money but still be similarly fulfilling (or even somewhat fulfilling?). only a small percentage of pre-meds likely have credentials to become engineers, financial analysts, etc (if they so wished to enter those fields or really any others, rather than medicine) so what do you suggest for those who just had a pre-med/biology bachelor's and are now questioning whether becoming a physician is a good investment for themselves - maybe a 2nd bachelor's degree to become something else? it seems like most careers will involve a life of long hours and work, but of course this is a large blanket statement and i am sure i may be wrong. i also feel whenever students are warned against becoming a physician there is little effort to identify viable alternatives so i would be interested in hearing what others have to say about this.
 
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Medicine in general is like slavery. Work >100 hours a week for a system that doesn't care about you.pick your specialty wisely. Anaesthetics is plush. Renal is by far the hardest and mentally draining, everyone of your patients is at death's door
🙄
 
Dear god, you might have to *gasp* get a condo or not live in Silicon Valley!
Most in the middle class have the mentality that a 2,000 sqft home is not big enough for a family of four. The consumerism economy attitude is destroying a lot middle class families financially.
 
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This, right here. Most "rich" people I know don't drive insane cars and live lavish lifestyles. They are extremely frugal, which is what got them to their position in the first place. Most Americans don't have the stomach to do what it takes to get there. They want everything now. That's why they're paying $500+/month for cars they really can't afford and not even setting up a budget to abide by each month. They're too busy keeping up with the Joneses and looking for the next thing to buy. Wealth is built, not bought. And doctors are certainly not immune to the "keeping up with the Joneses" mentality.

A friend of mine is a successful accountant with his own tax firm who drives a Ford when he could have afforded a Mercedes G-class. When people ask him why, he says that cars have among the biggest depreciation value of any asset/item.
 
Medicine in general is like slavery. Work >100 hours a week for a system that doesn't care about you.pick your specialty wisely. Anaesthetics is plush. Renal is by far the hardest and mentally draining, everyone of your patients is at death's door
In comparison to other specialties, anesthesiology might be "plush" outside the U.S. but unfortunately it's not "plush" in the U.S. Not with CRNAs, AMCs, anesthesiologists increasingly becoming employees, decreasing fair partnership tracks available, increasing hours, decreasing salaries, ACTs becoming the model of the future (already about 50% of all cases are done under an ACT model) so you'll most likely be supervising CRNAs rather than doing your own cases, etc. The specialty itself is very cool and interesting, but everything around the specialty not so much. Some anesthesiologists have it good, usually the older and more settled ones, but talk to anesthesiologists at different places in their careers like residents will have a different perspective than new attendings than attendings 10 years out etc. Also jobs tend to be better out West than East, but even the West isn't guaranteed to stay that way in the future. Check out the anesthesiology forum here to see what I mean.
 
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In comparison to other specialties, anesthesiology might be "plush" outside the U.S. but unfortunately it's not "plush" in the U.S. Not with CRNAs, AMCs, anesthesiologists increasingly becoming employees, decreasing fair partnership tracks available, increasing hours, decreasing salaries, ACTs becoming the model of the future (already about 50% of all cases are done under an ACT model) so you'll most likely be supervising CRNAs rather than doing your own cases, etc. The specialty itself is very cool and interesting, but everything around the specialty not so much. Some anesthesiologists have it good, usually the older and more settled ones, but talk to anesthesiologists at different places in their careers like residents will have a different perspective than new attendings than attendings 10 years out etc. Also jobs tend to be better out West than East, but even the West isn't guaranteed to stay that way in the future. Check out the anesthesiology forum here to see what I mean.
Many prefer supervision cases than solo though. It is nice being able to pop in/out of rooms as you please and not being chained to the anesthesia machine, but there is the increased stress of having to put out more fires.
 
OP might be right, but what he/she said is NOT unique to medicine. The world is not rosy anymore!

Yea things were so much better before. Damn you to hell child labor laws, organized labor, unions etc.
 
so then don't buy a 2 million dollar house............

What?! You're telling me as a doctor I might have to live in an 800k shack? It's as if the OP expected to be rubbing elbows with billionaires after becoming an MD. The fact is that you will be in the 90th+ percentile for income in one of the wealthiest countries in the world.

EDIT: Also I like how these threads that suggest that other great opportunities, outside of healthcare, exist NEVER mention those jobs. && I like OP putting in that nurses, techs, etc. are not colleagues. Those techs make $15/ hr and are either immigrants or first generation at best...eww
 
Many prefer supervision cases than solo though. It is nice being able to pop in/out of rooms as you please and not being chained to the anesthesia machine, but there is the increased stress of having to put out more fires.
Not to mention the liability risks (medico-legal) involved as the supervising physician.

But it won't really matter I guess since as things look now most future jobs will be ACT in some fashion. And most anesthesiologists likely employees (alongside other employees like CRNAs). Let's just hope anesthesiologists will be supervising fully compliant CRNAs who will call them in time or follow the anesthesia plan etc.

Or better yet that AAs become increasingly used everywhere, though their numbers are too small right now, so it's probably going to take a lot of years or maybe even a decade or two if not more before this happens on a broad enough scale so that anesthesiologists have an option besides CRNAs. This is assuming AAs get most states to approve too. Right now only around 15 or so states allow AAs. But even in many of these states there simply aren't enough AAs produced.
 
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All of this is relevant to the discussion at hand- one of the reasons OP cited for not being a physician was income. Many of us have voiced the opinion that it isn't as big of a concern as it seems, as even at 200k we'll be earning plenty. It's more than enough to invest with and make a good life for yourself. No idea how that concept got convoluted into some push for social justice lol.

Couple other things about the OP that bugged me- there are plenty of fields where you can work directly with colleagues, particularly in inpatient medicine. But even if you are working with non-physicians- why does that matter? We hung out together in the ED- physicians, nurses, techs, etc. Plenty of opportunity to socialize if you don't view non-physicians as somehow being beneath you.

Who needs a two million dollar home? I mean, seriously- I know tons of people that live in big coastal cities, zero of which have cracked 100k in income, so surely a physician can do it.

I do agree with the general sentiment though- medicine is certainly not what it once was. If you're in it for the lifestyle, be prepared for disappointment.
200,000$ for the amount of training and working 70 hours a week is absolute garbage. You could buy a nice car to drive you to and from work, and maybe afford a decent divorce lawyer when you hardly see your wife/kids.
Honestly i would be very unhappy with a pretax income of 200k. In fact with my debt and having kids, opprtunity cost from the years spent in training, that would be bad
 
200,000$ for the amount of training and working 70 hours a week is absolute garbage. You could buy a nice car to drive you to and from work, and maybe afford a decent divorce lawyer when you hardly see your wife/kids.
Honestly i would be very unhappy with a pretax income of 200k. In fact with my debt and having kids, opprtunity cost from the years spent in training, that would be bad

I'm curious to know what specialty has $200k and 70 hours/wk? Internal medicine? Family medicine?
 
200,000$ for the amount of training and working 70 hours a week is absolute garbage. You could buy a nice car to drive you to and from work, and maybe afford a decent divorce lawyer when you hardly see your wife/kids.
Honestly i would be very unhappy with a pretax income of 200k. In fact with my debt and having kids, opprtunity cost from the years spent in training, that would be bad

Wah wah wah then maybe do research before selecting a path to a profession that requires years of planning and research before even applying to train to become part of that profession. Maybe some of the time in those years should have been spent looking at finances and projected income instead of just going into medicine and then bitching about not getting enough pay once you're finally an attending. Disclaimer: I realize you may not actually be in this situation but this post and its attitude surely applies to some reading this.
 
Sitting here studying for some board exams, I thought I might take a break to give back to the community. This doesnt apply to all of you, but some of you may use this information to empower yourself. I just finished residency in a competitive specialty, I have a pretty good job locked in with a small amount of upside. One thing that is very clear however, is that the world passed by during training. There is alot more money and power and respect being earned out there and none of it is in being a clinician. Clinicians are increasingly entering the overworked middle class.

By becoming a clinician you are relegating yourself to a life of work, and depending on your specialty very hard work. For many of you, this is no big deal, you saw your parents do it and thats what you want to do. To you I say great, you understand the sacrifice and signed up for it with this understanding. For those that do not, you need to understand that you are committing your life to this, and your overall compensation will not be great. Clinical medicine is no longer a way to build a very good lifestyle. You can not scale this job any longer and private practice is becoming a thing of the past as we move to a centralized system. Just like many other fields outside of medicine, the older doctors understand this and are waiting to prey on young doctors. Again, this does not apply to everyone but I believe your generation is in for hard times in medicine bc the old guard has no concept of the younger generation.

I believe this is important for a few reasons. If you have to take a large debt to be a physician (there are ways to avoid this), dont do it. You can do great things for the world without being a doctor. Next, learn to live within your means. Dont go promising yourself or anyone that the payout is around the corner, it's not. If you want to live in a big city on the coasts, especially with a family, consider something that is not medicine (do the math; do you know the mortgage on a 2 million dollar home). Next, medicine is a loner path, you do not really work with your peers (nurses, techs, secretaries are not your peers). If you are a very social person, consider something else.

Many of you will have the capacity to be in different careers and do amazing things. If you have this capacity you need to question if clinical medicine is really the right thing given the way to world is moving. Otherwise stay realistic, understand the new world of medicine, and take the best care of patients you can and you will rock it. Good luck!

Let me guess radiology?
 
The point is student doctors feel disincentivized to work hard to get what they want in life. bc65 might want to live in Silicon valley which is incredibly reasonable seeing as to how he is a doctor and has worked his ass off all these years.

If there is an actual learning point for premeds in this inane thread, its to understand that Physician salaries are unique in that they are inversely correlated to your local living expenses. No other job works like that. If you're an engineer with Caterpillar in Peoria you make way less than if you work for Raytheon in DC, and that's OK because you also have a much lower cost of living. On the other hand a Pediatrician in Peoria can make 250K, while in DC many are making < 100K. Even the worst paid doctors can rapidly become truly wealthy in low cost of living areas, and even the best paid can struggle to feel middle class in the highest cost of living areas.

While law/medicine/finance is not actually a better financial decision than medicine for most people, if you are 100% certain you want to live in a micro economy with insane prices like Silicon Valley, DC, SoCal, or Manhattan then you are going to feel like you made the wrong career decision by going into medicine.

BTW OP is ridiculous. How can you be disappointed in your outsized paycheck before you've even gotten the first one? We graduated 9 days ago dude! Paychecks are supposed to be like pants: they seem like they give you a lot of room when you're young, but as you get older you start feeling squeezed and feel like you need a bigger size. If you're feeling squeezed by some of the biggest pants in the nation and you're barely 30 you need reflect on how much you're consuming.
 
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Even the worst paid doctors can rapidly become truly wealthy in low cost of living areas, and even the best paid can struggle to feel middle class in the highest cost of living areas.

When I tire of academics I'm going to take one of the rural New Hampshire jobs I keep getting emailed about that start at $375K.
 
"The U.S. Census Bureau reported in September 2014 that: U.S. real (inflation adjusted) median household income was $51,939"

No wonder high earners get slaughtered on taxes. Throw it all in investments and get taxed at capital gains rate, it's the only way to get and stay "rich".
 
If there is an actual learning point for premeds in this inane thread, its to understand that Physician salaries are unique in that they are inversely correlated to your local living expenses. No other job works like that. If you're an engineer with Caterpillar in Peoria you make way less than if you work for Raytheon in DC, and that's OK because you also have a much lower cost of living. On the other hand a Pediatrician in Peoria can make 250K, while in DC many are making < 100K. Even the worst paid doctors can rapidly become truly wealthy in low cost of living areas, and even the best paid can struggle to feel middle class in the highest cost of living areas.

While law/medicine/finance is not actually a better financial decision than medicine for most people, if you are 100% certain you want to live in a micro economy with insane prices like Silicon Valley, DC, SoCal, or Manhattan then you are going to feel like you made the wrong career decision by going into medicine.

BTW OP is ridiculous. How can you be disappointed in your outsized paycheck before you've even gotten the first one? We graduated 9 days ago dude! Paychecks are supposed to be like pants: they seem like they give you a lot of room when you're young, but as you get older you start feeling squeezed and feel like you need a bigger size. If you're feeling squeezed by some of the biggest pants in the nation and you're barely 30 you need reflect on how much you're consuming.

omg you're an attending now
 
This thread is hilarious. If you thought you were going to be making the money of a CEO by going into medicine, you're an idiot. At no time in history were doctors making that kind of money.

To act like the sky is falling even though you'll still be in the top 5% percent of earners makes you an entitled child.
 
There's one point that I think shouldn't be overlooked here... one of the most important thing driving a doctor is pride. Docs are usually a few std dev above their peers in grades on the path to med school, med school itself is a battle, and pride in one's ability and one's field is inculcated throughout all of training. IMO, being (or becoming) the point person is necessary to keep going for long hours under a great deal of stress (although obv, this might vary a little between specialties)

If one is successful at this whole doctor thing, then one often bumps up against the "upper class" (however you want to define it... "a wealth level above yours"), and suddenly you're the smaller potato. No doc likes feeling like the smaller potato. You didn't work harder than everyone else for over a decade (or decades) to not feel like a big potato. It's not always so much about accounting and numbers and savings and spending as it is to feel like you are "valuable"... which as one gets older and gets wrinkles and arthritis, is increasingly measured in money (or if you have a family, it's disguised as "providing for your family" or not letting your kids feel like they're underprivileged compared with their private school peers)... so the blithe response of "get your priorities straight" is appealing to a 20-30Y student who still measures success in terms of Step scores, but the priorities are different for a 40-50Y attending.

Personally, I don't think docs are underprivileged in terms of salary, but you sort of have to decide whether you want to be the big fish in the small pond or the small fish in the big pond. The idea that there are bigger fish in the big pond is going to be an issue for anyone who has been sacrificing and driving hard to be the best forever. I'm not saying it's reasonable, I'm saying as soon as you finish all your training, you won't be cool about being "undervalued", unless you're a saint. Most of us are not saints, no matter what we put on our personal statements. So being a middle-sized fish in a big pond for the rest of your life (while working harder than some other big fish) is something one should slowly and actively come to terms with rather than push off into the vague future. Don't just assume you're going to get professional satisfaction from something other than money... actively develop those avenues of professional satisfaction (teaching, pro bono care, etc.), so when the money is not what you expect it to be, you'll still feel like that invested decade was worthwhile.
 
There's one point that I think shouldn't be overlooked here... one of the most important thing driving a doctor is pride. Docs are usually a few std dev above their peers in grades on the path to med school, med school itself is a battle, and pride in one's ability and one's field is inculcated throughout all of training. IMO, being (or becoming) the point person is necessary to keep going for long hours under a great deal of stress (although obv, this might vary a little between specialties)

If one is successful at this whole doctor thing, then one often bumps up against the "upper class" (however you want to define it... "a wealth level above yours"), and suddenly you're the smaller potato. No doc likes feeling like the smaller potato. You didn't work harder than everyone else for over a decade (or decades) to not feel like a big potato. It's not always so much about accounting and numbers and savings and spending as it is to feel like you are "valuable"... which as one gets older and gets wrinkles and arthritis, is increasingly measured in money (or if you have a family, it's disguised as "providing for your family" or not letting your kids feel like they're underprivileged compared with their private school peers)... so the blithe response of "get your priorities straight" is appealing to a 20-30Y student who still measures success in terms of Step scores, but the priorities are different for a 40-50Y attending.

Personally, I don't think docs are underprivileged in terms of salary, but you sort of have to decide whether you want to be the big fish in the small pond or the small fish in the big pond. The idea that there are bigger fish in the big pond is going to be an issue for anyone who has been sacrificing and driving hard to be the best forever. I'm not saying it's reasonable, I'm saying as soon as you finish all your training, you won't be cool about being "undervalued", unless you're a saint. Most of us are not saints, no matter what we put on our personal statements. So being a middle-sized fish in a big pond for the rest of your life (while working harder than some other big fish) is something one should slowly and actively come to terms with rather than push off into the vague future. Don't just assume you're going to get professional satisfaction from something other than money... actively develop those avenues of professional satisfaction (teaching, pro bono care, etc.), so when the money is not what you expect it to be, you'll still feel like that invested decade was worthwhile.

Great post!

Seems like another aspect is where you live.. If you live and practice in one of the many areas of the US that people generally fly over, then even as an average MD you are basically among the richest people in the area. Whereas if you live/practice in a big city you will soon find tons of people with similar compensation to yours in all sorts of various fields (many that didn't require the med school/residency style training path)
 
For those who are not familiar with co-ops, they are the same as condo's. but they have a different ownership structure, in which you own a share in the building, which gives you the rights to your apartment, instead of owning the apartment outright. That means that you are subject to the co-op board approval before you can buy an apartment, and the buyers must be approved before you sell it. You also have limits on borrowing against the co-op or mortgaging it. So, in fact, co-ops are the least liquid and require the larger amount of cash up front. I have only encountered co-ops in NY, I don't know if they exist elsewhere.

If by co-op you might mean buy an apartment instead of a house, I'm talking about apartments, which are currently way above a million per bedroom for anything decent. There are very few free-standing homes in Manhattan. Usually, those are townhouses ("brownstones"). The nicer ones are foreign embassies and consulates for United Nations delegations. There are a very few real houses in Manhattan. The ones that still exist were all once the mansions of the very wealthy at one time, and are mostly museums now, but a few are in the hand of billionaires. Doctors usually can't afford brownstones or houses in Manhattan.

This is why people who live in Manhattan are stupid.

If you have to pay a million dollars for an appartment when for most others will get a large house and land for that and are happy about that as most manhattanites are... Well I think The DSM IV calls that shared delusional disorder.
 
This is why people who live in Manhattan are stupid.

If you have to pay a million dollars for an appartment when for most others will get a large house and land for that and are happy about that as most manhattanites are... Well I think The DSM IV calls that shared delusional disorder.

More importantly, there are few jobs where you have such stability and job security while making a very reasonable living. If you are ok with living not in Boston or Manhattan or sf, you can live exceptionally well as a doctor. In those cities not only are you paid less but your cost of living is astronomically higher. It doesn't make sense

those guys in finance/business/consulting are also iat risk of losing their job at anytime the market takes a downturn. Being a physician can weather this.
 
Not like the employed physician; the real upper class sits on the boards that control the hospital system and make the rules.
To compare doctor's income to others look at how many foreclosed houses were owned by doctors. Others might have high income temporarily but not on a consistent way.
A doctor could live anywhere with a decent income while others will loose a good portion of their income if they move.
You only benefit from investment when you have steady decent income, otherwise you are taking a risk.
 
I hear cosmetic plastic surgery is on the rise in SF, SV, and Manhattan. OP, you should consider a career switch!
 
,
If there is an actual learning point for premeds in this inane thread, its to understand that Physician salaries are unique in that they are inversely correlated to your local living expenses. No other job works like that. If you're an engineer with Caterpillar in Peoria you make way less than if you work for Raytheon in DC, and that's OK because you also have a much lower cost of living. On the other hand a Pediatrician in Peoria can make 250K, while in DC many are making < 100K. Even the worst paid doctors can rapidly become truly wealthy in low cost of living areas, and even the best paid can struggle to feel middle class in the highest cost of living areas.

While law/medicine/finance is not actually a better financial decision than medicine for most people, if you are 100% certain you want to live in a micro economy with insane prices like Silicon Valley, DC, SoCal, or Manhattan then you are going to feel like you made the wrong career decision by going into medicine.

BTW OP is ridiculous. How can you be disappointed in your outsized paycheck before you've even gotten the first one? We graduated 9 days ago dude! Paychecks are supposed to be like pants: they seem like they give you a lot of room when you're young, but as you get older you start feeling squeezed and feel like you need a bigger size. If you're feeling squeezed by some of the biggest pants in the nation and you're barely 30 you need reflect on how much you're consuming.

Lol. Yeah why do you see this difference? Why does "a Pediatrician in Peoria can make 250K, while in DC many are making < 100K." Think about that for a second. And actually this isn't entirely true (adjusted for cost of living, yes, rural physician have more purchasing power, but on average rural physicians have very similar salaries to urban)

"How can you be disappointed in your outsized paycheck before you've even gotten the first one?"

Probably b/c his paycheck isn't actually going to be, relatively speaking, very big for the amount of sacrifice he's made (partly b/c he has to make big debt payments to pay off his loans)
 
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guys guys, so many assumptions, so med student of you. This is not about me and my situation, it is about you. I was fortunate to buy a house during med school for cheap and sell it in one of these crazy markets for 5 times cost so I have plenty of money. As I stated explicitly my point here was to highlight 3 things. If you have to take a big loan to be a doctor, dont do it. If you want to live in a big city, probably shouldnt do it. If you dont want to live within your means dont do it. Many a med school classmate is banging his or her head because they didnt follow this advice. I wouldn't say this advice is particularly controversial

For the people that actually do strive to be great at whatever, teaching/research/academics/money making/fly fishing, you will quickly learn that people will try to hold you back, lots of people. All those people that are saying 200k is this crazy amount bc you live in the richest country, these people strive for mediocrity and will try to hold you back. Dont listen to them or you will find yourself in their situation. Mind you their situation isnt bad, mediocre is a hell of alot better than way less than mediocre. But medicine is filled with mediocre people, why do you think they chose medicine?

Now, more importantly, this is not an issue of money. It is an issue of power. Physicians are going the way of a wage laborer. And hospitals love that. They want you to be burried in nonsensical paperwork or insurance justifications. It works well for them and we cede significant control and power and are at the mercy of administration whims. Our generation will need to decide if we want this. It is not about money, it is about power. They like when you get giggly over 200k, because that is a small price to control you. They love mediocre people. 200k for your training and hours is a terrible financial decision (even rn's make 75-80k for 3 days a week, NPs 95k for normal hours).
 
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I appreciate the OP's quote, and I am concerned about the diminishing power of physicians, especially as I watch private practices disappear. Not only are we placing our paychecks in the hands of other people, but we are ultimately placing patient care decisions in their hands as well.

I would like to make one comment as far as finances go. If you are just starting the path to medicine, this should be your mantra: You can either live rich, or be rich. It's true, 200k is a lot of money. But it's not going to finance your BMW's, your mansion house, your world travels, AND your giant investment fund. Pick one or the other. True, there are exceptions, but if you have this mindset then you're chances of being disappointed are going to be much lower.
 
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I appreciate the OP's quote, and I am concerned about the diminishing power of physicians, especially as I watch private practices disappear. Not only are we placing our paychecks in the hands of other people, but we are ultimately placing patient care decisions in their hands as well.

I would like to make one comment as far as finances go. If you are just starting the path to medicine, this should be your mantra: You can either live rich, or be rich. It's true, 200k is a lot of money. But it's not going to finance your BMW's, your mansion house, your world travels, AND your giant investment fund. Pick one or the other. True, there are exceptions, but if you have this mindset then you're chances of being disappointed are going to be much lower.

I will take be rich for $800, Alex.
 
guys guys, so many assumptions, so med student of you. This is not about me and my situation, it is about you. I was fortunate to buy a house during med school for cheap and sell it in one of these crazy markets for 5 times cost so I have plenty of money. As I stated explicitly my point here was to highlight 3 things. If you have to take a big loan to be a doctor, dont do it. If you want to live in a big city, probably shouldnt do it. If you dont want to live within your means dont do it. Many a med school classmate is banging his or her head because they didnt follow this advice. I wouldn't say this advice is particularly controversial

For the people that actually do strive to be great at whatever, teaching/research/academics/money making/fly fishing, you will quickly learn that people will try to hold you back, lots of people. All those people that are saying 200k is this crazy amount bc you live in the richest country, these people strive for mediocrity and will try to hold you back. Dont listen to them or you will find yourself in their situation. Mind you their situation isnt bad, mediocre is a hell of alot better than way less than mediocre. But medicine is filled with mediocre people, why do you think they chose medicine?

Now, more importantly, this is not an issue of money. It is an issue of power. Physicians are going the way of a wage laborer. And hospitals love that. They want you to be burried in nonsensical paperwork or insurance justifications. It works well for them and we cede significant control and power and are at the mercy of administration whims. Our generation will need to decide if we want this. It is not about money, it is about power. They like when you get giggly over 200k, because that is a small price to control you. They love mediocre people. 200k for your training and hours is a terrible financial decision (even rn's make 75-80k for 3 days a week, NPs 95k for normal hours).
You do realize there is an entire world out there that exists outside of your elitist point of view? Again, if you earn more than 90% of Americans (and not to mention billions of other people on this planet in not so fortunate places), you are far from mediocre. I don't think that word means what you think it means.
 
For the people that actually do strive to be great at whatever, teaching/research/academics/money making/fly fishing, you will quickly learn that people will try to hold you back, lots of people. All those people that are saying 200k is this crazy amount bc you live in the richest country, these people strive for mediocrity and will try to hold you back.

It sounds like someone read Ayn Rand and never got over it.
 
This is why people who live in Manhattan are stupid....

I guess, but you aren't really disputing their argument that lots of doctors are having to endure long car and commuter rail commutes in from Jersey or Brooklyn because they can't afford anything within quite a few miles of where they work. To me that's not the sign of someone who has made it big. To many, NYC (and SF and Boston) can be an eye opener because you may never have realized how poor you really are until you price what it would cost to live there. There's a reason most sitcoms which take place in Manhattan depict apartment living with multiple roommates. If you have a long commute to work in those regions you are probably middle class. Upper class in Manhattan means you only change zip codes when you summer in the Hamptons.
 
Sitting here studying for some board exams, I thought I might take a break to give back to the community. This doesnt apply to all of you, but some of you may use this information to empower yourself. I just finished residency in a competitive specialty, I have a pretty good job locked in with a small amount of upside. One thing that is very clear however, is that the world passed by during training. There is alot more money and power and respect being earned out there and none of it is in being a clinician. Clinicians are increasingly entering the overworked middle class.

By becoming a clinician you are relegating yourself to a life of work, and depending on your specialty very hard work. For many of you, this is no big deal, you saw your parents do it and thats what you want to do. To you I say great, you understand the sacrifice and signed up for it with this understanding. For those that do not, you need to understand that you are committing your life to this, and your overall compensation will not be great. Clinical medicine is no longer a way to build a very good lifestyle. You can not scale this job any longer and private practice is becoming a thing of the past as we move to a centralized system. Just like many other fields outside of medicine, the older doctors understand this and are waiting to prey on young doctors. Again, this does not apply to everyone but I believe your generation is in for hard times in medicine bc the old guard has no concept of the younger generation.

I believe this is important for a few reasons. If you have to take a large debt to be a physician (there are ways to avoid this), dont do it. You can do great things for the world without being a doctor. Next, learn to live within your means. Dont go promising yourself or anyone that the payout is around the corner, it's not. If you want to live in a big city on the coasts, especially with a family, consider something that is not medicine (do the math; do you know the mortgage on a 2 million dollar home). Next, medicine is a loner path, you do not really work with your peers (nurses, techs, secretaries are not your peers). If you are a very social person, consider something else.

Many of you will have the capacity to be in different careers and do amazing things. If you have this capacity you need to question if clinical medicine is really the right thing given the way to world is moving. Otherwise stay realistic, understand the new world of medicine, and take the best care of patients you can and you will rock it. Good luck!

Eh. We hear this everyday in dozens of other threads. I also see lots of positive threads. Who knows what to think at this point.
 
Eh. We hear this everyday in dozens of other threads. I also see lots of positive threads. Who knows what to think at this point.

If I may, I'd suggest thinking that the truth probably lies somewhere in the middle.

I'm not going to get into the exact specifics of my compensation but I live in a metro of about 500k, have a nice and new house that is around 3000 square feet with all those "finishes" everyone want to have these days that I didn't have to pay a half million dollars for, two nice vehicles, money for private school and club soccer, all the while maxing out my 403, went on two non extravagant vacations last year, still have money for savings. I get to see my wife and kids. I work out without too much trouble most of the time. I'm always training for a half marathon. My hours are 40 to 50 most weeks unless I'm covering the weekend which happens every other month. Work hard. Play hard. The sky could fall but doesn't seem to have done so yet. I still think medicine is a great and rewarding profession that will continue to pay better than most jobs well into the forseeable future.
 
If I may, I'd suggest thinking that the truth probably lies somewhere in the middle.

I'm not going to get into the exact specifics of my compensation but I live in a metro of about 500k, have a nice and new house that is around 3000 square feet with all those "finishes" everyone want to have these days that I didn't have to pay a half million dollars for, two nice vehicles, money for private school and club soccer, all the while maxing out my 403, went on two non extravagant vacations last year, still have money for savings. I get to see my wife and kids. I work out without too much trouble most of the time. I'm always training for a half marathon. My hours are 40 to 50 most weeks unless I'm covering the weekend which happens every other month. Work hard. Play hard. The sky could fall but doesn't seem to have done so yet. I still think medicine is a great and rewarding profession that will continue to pay better than most jobs well into the forseeable future.

Thanks for the dose of reality!
 
If I may, I'd suggest thinking that the truth probably lies somewhere in the middle.

I'm not going to get into the exact specifics of my compensation but I live in a metro of about 500k, have a nice and new house that is around 3000 square feet with all those "finishes" everyone want to have these days that I didn't have to pay a half million dollars for, two nice vehicles, money for private school and club soccer, all the while maxing out my 403, went on two non extravagant vacations last year, still have money for savings. I get to see my wife and kids. I work out without too much trouble most of the time. I'm always training for a half marathon. My hours are 40 to 50 most weeks unless I'm covering the weekend which happens every other month. Work hard. Play hard. The sky could fall but doesn't seem to have done so yet. I still think medicine is a great and rewarding profession that will continue to pay better than most jobs well into the forseeable future.

Good for you man. That sounds comfortable and what many people dream of. Also, keep in mind if you ask anyone who is already a doctor about this they will have, at a minimum, an opinion that is at least 7 years old. Meaning that they paid 33% less for their medical education than you will and with interest of 6% a year, that number increases to nearly 40%.
 
Good for you man. That sounds comfortable and what many people dream of. Also, keep in mind if you ask anyone who is already a doctor about this they will have, at a minimum, an opinion that is at least 7 years old. Meaning that they paid 33% less for their medical education than you will and with interest of 6% a year, that number increases to nearly 40%.

And the house I bought would have been 33 to 40% cheaper a few year ago. Salaray was also 33 to 40% less. It's all some what relative. You're only a victim of you choose to be.
 
And the house I bought would have been 33 to 40% cheaper a few year ago. Salaray was also 33 to 40% less. It's all some what relative. You're only a victim of you choose to be.

.......

"Salaray was also 33 to 40% less."
Nope. Wrong
Pysicians' salaries have not matched the rate of inflation
 
.......
"Salaray was also 33 to 40% less."
Nope. Wrong
Pysicians' salaries have not matched the rate of inflation

Well. Not strictly, but pay has generally gone up. My specialty has. Hell, I'm getting a raise this year.

Here's the bottom line though, if you don't want the debt and don't think the job is worth it, then don't do it.

When I wasn't paying attention did a rash of gunmen start forcing folks into medical school and the loans?

I still maintain despite those loans, medicine is still a great profession. And there are reasonable strategies from out from under those loans or a large portion of those loans by living modestly for a few more years after you finish your training or consolidating and refinancing the loan over 30 years. Does it suck that this is the continuing cost of getting to be a physician? Sure. But when life gets to be "fair," you let me know, because hell just froze over and there are a few awkward dates I will have to go on and a few more awkward favors I'm going to need to do. Reality's a bitch, but whining about it does very little for you and nothing about reality itself. It doesn't care. Didn't ask your opinion.
 
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