Seriously ???

[imallday17]

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Athe 7-12 years of killing yourself, you get to a point where you actually get to say, I am finally out on my own and working towards paying down my 200K+ debt......reality check.....is it true what i read on SDN and the internet???

Coming out of residency/fellowship are we only going to be making 80-100K a year??? And just how many more years do we have to accept that pay before we get to these "mythical" figures i keep reading about??? I dont need 500k a year at all... But i do know Ive had to sacrifice and pay for too much of my own things thus far; theres no way Id let my kid go through what I did...

Exactly how expensive is malpractice anyway??? My fiance and I are expecting a child and obviously need to have decent income, especially with 0 residual in MS and not much in res/fellow (we dont need to live great)(as long as the child is set im perfect)... Money isnt everything, nor should it be... But when do you actually get to the point where you pay down your debt, and start investing and get to the point where you are money ahead???

 

[Pinkertinkle]

A lot of salary or malpractice depends on the specialty you are in, any ideas on that?

 

[H_Caulfield]

Ehh...it's true, yes, but not so bad as you make it seem. What's going around on SDN is indicative of the way it is, but the examples given are always the worst ones, and things are conveniently left out of the equation. Yes, you'll make no money and work "hard" for four years (really it's pretty relaxing, unless you consider sitting around with coffee and a book for several hours per day "hard"), but it won't be the seven payless years you mention: you're paid about 40-50k for each year of residency (more than the national average just to TRAIN). If you do a 6 or 7 year residency you'll be making 60 by the end of it.

Your 80-100k quote is also a little off. After 4 years of sitting with that book in med school, another 3 of being paid 50k while soaking up interesting experiences and feeling important (a new "doctor:" nice feeling, probably), you're likely even as a general practitioner to make something more like 120-150k after malpractice. Even if you choose something like surgery, you'll need to think of it as tacking 2 years (or more) onto your residency, which you'll be better compensated for than you were for the first 3, and then ultimately making 200+ thereafter, all while doing something fascinating that nobody else in the country can do without being arrested.

See how it's about linguistics? Just stop listening to embittered people and you'll feel much better about it.

 

[Winged Scapula]

The question of malpractice can only be answered by knowing the field and the location you will be practicing in.

For example, I will be practicing surgery in the Phoenix area. My med mal the first year is about $7K, it will max out around $50K in about 4 years (or so they say now). I have friends practicing in Pennsylvania, Philly area, who pay twice that. Although there were many other reasons, the salaries there weren't high enough to take the malpractice rates into account (for me to stay).

Ob-Gyn and Neurosurg can be even more. Radiology and Path can have high rates as well, something not often realized. If you are a hospital employee, part of your employment package will include malpractice insurance coverage. In private practice, you are responsible for it.

Basically, there is no way to answer your question right now without knowing the above factors.

 

[MossPoh]

I'd say 80k would be the lowest of the low. That is nowhere near the average. I've heard of about as many of those situations as guys pulling in 900k+ (not many).

As stated earlier, you'll pull in enough during residency to support your family. It isn't necessarily great money for the amount of time investment...but it'll support them. If you have visions of sending your kid to a nice private school, paying off a car, and buying a house during residency then I'd change that view. Unless the car is a used kia, and the house is a nice starter home. Compared to the old days, residents are loaded with cash. My dad did his residency in Manhattan and the Bronx. He was paid about 100 dollars a month...granted it was during the 60s, that still isn't much, especially when you factor in 2 kids to take care of.

If you hire a financial advisor (after residency unless you are friends with one), stay within your limits, and just keep your spending habits in check then you'll make PLENTY of money to pay off those loans and everything else.

 

[Law2Doc]

I'd say 80k would be the lowest of the low. That is nowhere near the average. I've heard of about as many of those situations as guys pulling in 900k+ (not many).

Nobody comes out of residency and earns 900k. If that ever happened (which I doubt), it does not anymore. Quite a few do end up below six digits after insurance costs, although that is below average, even for the lower paying specialties. But an "average" always means that some will earn a bit less. (It doesn't however tend to mean that people will earn 5 times as much).

As for supporting a family during residency, lots of Americans manage on $40k, although it is certainly a no frills, paycheck to paycheck existence.

 

[jbrice1639]

$80k is definitely low. even in primary care, that's not anywhere near the mean. for example, i looked up the salary range for an internist in chicago (since we all know everyone on sdn will say all primary care docs are "poor") and the low end of the spectrum was still over $100k.

http://chidocsalary.notlong.com

 

[imallday17]

yeah reading the pre-allo board all day checking out all the $$$ type threads does me no good... i see nothing but the thread get flamed and really biased responses... (alot of those threads may deserve it though)...

i gave up a couple professional baseball free agent opportunities to pursue medicine... but with the "family to be" in the picture i was just wanting some advice from some of you who have been through it already... if i wanted money in large sums and right now, id pick another route... i understand the malpratice changes with location, specialty, and hosp/private, i just didnt see how one could make (hypothetically) 80K a year after the knowledge and experience one gained..
i just want quality of life i think, with my family... the money will be there... i just want to be able to practice medicine and maintain a great realtionship with my family.... can i have the best of both worlds???

 

[Law2Doc]

$80k is definitely low. even in primary care, that's not anywhere near the mean. for example, i looked up the salary range for an internist in chicago (since we all know everyone on sdn will say all primary care docs are "poor") and the low end of the spectrum was still over $100k.

http://chidocsalary.notlong.com

There was an article run on one of the headhunter sites a few years back about FPs in certain tight markets earning in the $80-90k range. It is not the norm, but is not unheard of.

 

[imallday17]

speaking of that... where can you go to get a good "unbiased" or the least biased numbers for earnings and years or practice??? ive heard freida but then ive heard a number of people bash them for not being realistic

 

[Law2Doc]

speaking of that... where can you go to get a good "unbiased" or the least biased numbers for earnings and years or practice??? ive heard freida but then ive heard a number of people bash them for not being realistic

These JAMA numbers are a few years old, but honest.

http://www.medfriends.org/specialty_hours_worked.htm

 

[H_Caulfield]

speaking of that... where can you go to get a good "unbiased" or the least biased numbers for earnings and years or practice??? ive heard freida but then ive heard a number of people bash them for not being realistic

The 2006 Physician Salary Report. You'll have to sneak into a med school's library to read it, though.

 

[imallday17]

shouldnt be too bad,, ive got 3 days left here at hopkins before moving on so ill try to get in there tom... i appreciate it so far...

 

[TRAMD]

It is VERY EASY to make over 120k (salary after expenses, but before taxes) in ANY specialty, usually your first year, but by at least your third. It is also VERY POSSIBLE to make over 200k in ALL specialties by your third year, but you will have to work harder, be better and be luckier in certain specialties to do that. There is actually surprisingly little difference in physician salaries between their 2nd-3rd year and their 30th year in practice (after adjusting for inflation). I have no hard numbers on this, but almost all physicians make 6 figures with most clustered in the 140k-250k range. Very few make 5 figures (unless intentionally working fewer hours per week or weeks per year) and even less make 7. If you are intending to work full-time, chose the specialty you like and you will do better than good. The respect, admiration and kindness you will receive as a physician is worth even more in my opinion. You will not regret your decision to become a physician. If you like your specialty, you will enjoy residency and can live a comfortable life with a tight budget.

 

[deleted87716]

It is VERY EASY to make over 120k (salary after expenses, but before taxes) in ANY specialty, usually your first year, but by at least your third. It is also VERY POSSIBLE to make over 200k in ALL specialties by your third year, but you will have to work harder, be better and be luckier in certain specialties to do that. There is actually surprisingly little difference in physician salaries between their 2nd-3rd year and their 30th year in practice (after adjusting for inflation). I have no hard numbers on this, but almost all physicians make 6 figures with most clustered in the 140k-250k range. Very few make 5 figures (unless intentionally working fewer hours per week or weeks per year) and even less make 7. If you are intending to work full-time, chose the specialty you like and you will do better than good. The respect, admiration and kindness you will receive as a physician is worth even more in my opinion. You will not regret your decision to become a physician. If you like your specialty, you will enjoy residency and can live a comfortable life with a tight budget.

I concur. 🙂👍

 

[imallday17]

yeah i have alot of family friends in medicine, but the majority of them went through school in the 60s or 70s.. medicine changes by the day i know, so im sure things are vastly different now than when they came through... im aware of the intangible perks that comes with being a dr, with all money aside.. and i do beleive even as hard as it is, if you love what your doing itll make it easier/more enjoyable... but like i posted earlier, maybe i want tooo much... wanting the best of both worlds....family time, money for them, and medicine as a career...

 

[imallday17]

the one thing i havent been able to do is get the opinions and feedback from res/fellows that are very much in the midst of it, or are just finishing up... and the couple that i have had the luxury of talking to were both single and werent even thinking about family.. one was academia and the other not...

so i was hoping to look to SDN for that.. i just hate seeing the threads where people blow them up with negative outlooks and quote the worst of the worst scenarios.. i know itll be hell, i just want to know theres light too, ya know

 

[TRAMD]

yeah i have alot of family friends in medicine, but the majority of them went through school in the 60s or 70s.. medicine changes by the day i know, so im sure things are vastly different now than when they came through... im aware of the intangible perks that comes with being a dr, with all money aside.. and i do beleive even as hard as it is, if you love what your doing itll make it easier/more enjoyable... but like i posted earlier, maybe i want tooo much... wanting the best of both worlds....family time, money for them, and medicine as a career...

Of course, but you will have to pick a field with more time off such as Spine Surgery, Interventional Pain, Radiology, Pathology, Dermatology, Radiation Oncology, ER, Allergy/Immunology, Physiatry, Neurology, Psychiatry, Infectious Disease, Rheumatology, Occupational Medicine or Endocrinology. Of course, that isn't very many to choose from . . . hah. There are exceptions within these specialties and others where you can make them a lifestyle specialty in the right situation with no/little call and self-limited hours (such as Plastics, Ophthalmology, Family or Ortho). Enjoy, it is a very fun choice to make.

 

[imallday17]

yeah i think that will have to be a game time decision.. ive been exposed to about 5 % of those fields... ill work on trying to shadow a few different depts. i appreciate the insight everyone... anyone else have any suggestions or rebutles???

 

[Winged Scapula]

yeah i think that will have to be a game time decision.. ive been exposed to about 5 % of those fields... ill work on trying to shadow a few different depts. i appreciate the insight everyone... anyone else have any suggestions or rebutles???

Why are you trying to decide on a field when you aren't even in medical school yet?

I understand the financial concerns you have but IMHO its unrealistic to try to expose yourself to the bigger money/fewer hours fields and:

a) really know what they are going to be like
b) whether or not you will be competitive enough to match into them years from now
c) whether or not you will really be interested in them years from now

It is unlikely you will ever make the kind of money in medicine that you could have had you become a professional ball player...even if you weren't in the A Rod or Jeter leagues. However, you can make a good salary, much more than the average American and support a family, a family you can spend time with. The only reliable source for salaries is the MGMA survey which costs about $400, so you would want to try and find it in the library. The AAMC also produces a book about salaries for academic physicians, stratified by specialty and geographic area.

 

[cfdavid]

There was an article run on one of the headhunter sites a few years back about FPs in certain tight markets earning in the $80-90k range. It is not the norm, but is not unheard of.

Then, I guess it's time for those FP's to move OUT of those "tight" markets. That's ridiculous.

 

[imallday17]

no i never said i knew or was planning a specialty at this point, someone else volunteered those specialty suggestions... i said i have only been exposed to 5 % of them and it "would" be a game time decision then.... def. not now, too many things change, personally and in medicine to try and predict what youll be 8-9 years from now.... plus there are plenty of steps to take and tests to score highly on to plan it now... i know this... i just wanted advice from you all who have been there, on issues regarding the OP

sorry for any misleading info ... thanks again to all so far

 

[dutchman]

Athe 7-12 years of killing yourself, you get to a point where you actually get to say, I am finally out on my own and working towards paying down my 200K+ debt......reality check.....is it true what i read on SDN and the internet???

Coming out of residency/fellowship are we only going to be making 80-100K a year??? And just how many more years do we have to accept that pay before we get to these "mythical" figures i keep reading about??? I dont need 500k a year at all... But i do know Ive had to sacrifice and pay for too much of my own things thus far; theres no way Id let my kid go through what I did...

Exactly how expensive is malpractice anyway??? My fiance and I are expecting a child and obviously need to have decent income, especially with 0 residual in MS and not much in res/fellow (we dont need to live great)(as long as the child is set im perfect)... Money isnt everything, nor should it be... But when do you actually get to the point where you pay down your debt, and start investing and get to the point where you are money ahead???

It is concievable that by the time you are done with your training, physicians will in fact be earning 80-100k, with >200K debt, and rising malpractice insurance.

I touched on three things in that sentence, declining salaries, rising cost of medical education, and an out of control tort system. Look at the trends for each one, and you will see what I am saying.

 

[Law2Doc]

Then, I guess it's time for those FP's to move OUT of those "tight" markets. That's ridiculous.

LOL -- that's reminiscent of the old Sam Kineson bit where he yells at the starving ethiopians for not moving to where the food is. 🙂

 

[Winged Scapula]

no i never said i knew or was planning a specialty at this point, someone else volunteered those specialty suggestions... i said i have only been exposed to 5 % of them and it "would" be a game time decision then.... def. not now, too many things change, personally and in medicine to try and predict what youll be 8-9 years from now.... plus there are plenty of steps to take and tests to score highly on to plan it now... i know this... i just wanted advice from you all who have been there, on issues regarding the OP

sorry for any misleading info ... thanks again to all so far

Gotcha...sorry I misunderstood and ranted on ya!😉

 

[imallday17]

all is well.... 🙂

 

[BlackSails]

Nobody comes out of residency and earns 900k. If that ever happened (which I doubt), it does not anymore.

I spoke to a 6th year nsgy resident who says he has been offered a starting salary of 700k by some group out in the midwest. Granted, I have no idea if what he says is true, but thats what I was told.

 

[Miami_med]

LOL -- that's reminiscent of the old Sam Kineson bit where he yells at the starving ethiopians for not moving to where the food is. 🙂

Now now, tight markets are tight because there are too many people trying to do something there. Aka, supply is exceeding demand. If you demand to practice a specific specialty in a specific market that doesn't need you, you'll actually have to compete, and in competition, you may not do as well. In other words, entering a saturated market confers risk. Even in FP, Peds, IM, there are markets that will almost guarantee you $175k+ if you graduate at all, and there are people making big salaries in all markets (even the saturated ones). The more saturated the market, the greater the risk of making less (though it is never 100%). Don't do FP in Manhattan if you want a promise that you will make a good living. Most still will.

 

[Green Chimneys]

i gave up a couple professional baseball free agent opportunities to pursue medicine... but with the "family to be" in the picture i was just wanting some advice

Well I'll tell you one thing, medicine will definitely be a more sound career path for taking care of your family than milling around the minor league baseball circuit. No matter how good you are, the odds of you making the big leagues and landing a big paycheck were extremely slim. At least with medicine, you know that enough hard work and dedication is virtually guaranteed to land you in the "majors." Good luck.

 

[Law2Doc]

Now now, tight markets are tight because there are too many people trying to do something there. Aka, supply is exceeding demand. If you demand to practice a specific specialty in a specific market that doesn't need you, you'll actually have to compete, and in competition, you may not do as well.

I agree. I was just pointing out that not everyone will move just because money is better elsewhere. If you complete your residency with no entanglements, you can play "free agent", test the market, and go wherever the demand is highest. Many people who come out of residency in their late 20s and beyond no longer have that flexibility -- if the market where you have to live is tight, it's tight. So no "go to where the food is". 🙂

 

[mjl1717]

There was an article run on one of the headhunter sites a few years back about FPs in certain tight markets earning in the $80-90k range. It is not the norm, but is not unheard of.

In all seriousness this IS true!

 

[imallday17]

ok.. So should I follow the money in the investment/business worlds or do what my heart tells me and follow MS, getting out of residency at like 37 years old (ill be 27 as an MS1), 200+ in debt, "hope" to land a semi-time friendly job and hopefully pick up a woman somewhere in the mix of it 😎?????

 

[H_Caulfield]

ok.. So should I follow the money in the investment/business worlds or do what my heart tells me and follow MS, getting out of residency at like 37 years old (ill be 27 as an MS1), 200+ in debt, "hope" to land a semi-time friendly job and hopefully pick up a woman somewhere in the mix of it 😎?????

In the investment and business careers you're starting out at the bottom, and it will take you to age 37 to build yourself up to the level at which you're hoping to be. You'll only be a resident until you're that old if you choose neurosurgery, transplant surgery, interventional neuroradiology, or one of just a few other fields, and even then you'll make money throughout your residency years. If that still sounds too much to you like putting your life on hold, choose IM, EM, or some other field that will allow you to moonlight, in which case you can make something like that investment or business salary after just 4 years of school.

Not targeting the OP, but I'm tired of everyone thinking of the end of residency as being the time at which you start practicing as a doctor. You're a doctor right after med school; you get up every morning, get to the hospital, and make what's now some pretty decent money. That's called "working".....

 

[dilated]

Not targeting the OP, but I'm tired of everyone thinking of the end of residency as being the time at which you start practicing as a doctor. You're a doctor right after med school; you get up every morning, get to the hospital, and make what's now some pretty decent money. That's called "working".....

Residents here make <45k. That's significantly below the average starting salary for graduates of my undergrad. Which is ignoring the 4 extra years of education and average 120k debt. It sure is "working", but I'm not sure that's "pretty decent money".

 

[swpm]

Yes, you'll make no money and work "hard" for four years (really it's pretty relaxing, unless you consider sitting around with coffee and a book for several hours per day "hard"), but it won't be the seven payless years you mention: you're paid about 40-50k for each year of residency (more than the national average just to TRAIN)

Well, that's one (fringe) view of residency, to say the least. 🙂

While you're relaxing with your coffee, don't forget to subtract the $5-10K in student loan interest from that "pretty decent" $10/hour resident salary.

 

[H_Caulfield]

Well, that's one (fringe) view of residency, to say the least. 🙂

While you're relaxing with your coffee, don't forget to subtract the $5-10K in student loan interest from that "pretty decent" $10/hour resident salary.

You can defer your loans with minimal interest for like ten years. I'm not saying residency salary is anything to be envious of, but I think it's worth noting that it's probably twice as high as it used to be and is about as much as some starting lawyers and accountants make. Highschools, colleges, and medical schools are filled with people who have crazy expectations about what they'll be making immediately after finishing their schooling. I still remember kids at my college, planning to graduate with that biology degree and make "at least 50 grand right away." 37k is more like it, in almost all cases involving starter jobs...making that 40-some-thousand the average PGY-3 is paid look alright, especially when you consider that you're in the middle of investing in something that'll pay you back dozens of times over.

 

[imallday17]

i have def. heard the debate about residents salaries... i know it changes depending on location and hospital... but if you are making upper 30s to low 40s in your IM residency, what if you chose to go cards or endo or anything afterwards?? Do you stay at that pay level or do you gradually climb the ladder 2 or 3K a year??? BC unless my SO plans on working fulltime with a child i may be ____ up a creek when im 33-35 and finishing which ever residency i chose haha... although i will be able to pay it back and everyone else ive ever owed 🙄

 

[pagemmapants]

Well, that's one (fringe) view of residency, to say the least. 🙂

While you're relaxing with your coffee, don't forget to subtract the $5-10K in student loan interest from that "pretty decent" $10/hour resident salary.

That's what moonlighting is for.

(Sleep. . . psht. Who needs that?)

 

[Cirrus83]

I spoke to a 6th year nsgy resident who says he has been offered a starting salary of 700k by some group out in the midwest. Granted, I have no idea if what he says is true, but thats what I was told.

If this is true it must be for some place in the midwest where there are basically no neurosurgeons around at all and they're just desperate as heck for one. Of course this also means that it's most likely in the middle of nowhere in an area that doctors avoid like the plague, so while money is nice I dunno if I'd be able to avoid going crazy living in the middle of nowhere (no offense to the people who are from the middle of nowhere).

 

[Cirrus83]

i have def. heard the debate about residents salaries... i know it changes depending on location and hospital... but if you are making upper 30s to low 40s in your IM residency, what if you chose to go cards or endo or anything afterwards?? Do you stay at that pay level or do you gradually climb the ladder 2 or 3K a year??? BC unless my SO plans on working fulltime with a child i may be ____ up a creek when im 33-35 and finishing which ever residency i chose haha... although i will be able to pay it back and everyone else ive ever owed 🙄

Most places will tell you how much they pay for PGY1, PGY2, PGY3, PGY4, PGY5, 6, 7, 8, whatever. Basically that's how pay is determined.

Generally speaking it keeps climbing during your fellowship.

But of course the real climb is when you finally finish all your post graduate training and your salary basically goes nuts...it's really pretty bizarre how physicians can have their salary quadruple (or even more depending on your specialty) from one year to the next after residency.

 

[TRAMD]

If this is true it must be for some place in the midwest where there are basically no neurosurgeons around at all and they're just desperate as heck for one. Of course this also means that it's most likely in the middle of nowhere in an area that doctors avoid like the plague, so while money is nice I dunno if I'd be able to avoid going crazy living in the middle of nowhere (no offense to the people who are from the middle of nowhere).

I am from the midwest. Our definitions are probably different but they don't have neurosurgeons in the "middle of nowhere", nor are they trying to recruit them. A place with a neurosurgeon will almost certainly be a town of at least 50,000 and will probably serve an area over 250,000. These probably sound small to people from the edges of the country, but are desirable to some. There are not millions of people around--which in my opinion just makes for horrendous traffic, more pollution and more crime. Commutes to work are almost always less than 15 minutes and likewise in about 15 minutes you can be almost totally alone (the "middle of nowhere" to some). There are no professional sports teams, fewer museums, less fantastic architecture, fewer overpriced restaurants and fewer fine shows and entertainment venues but all of those don't mean much to me (except architecture, I love cool buildings). Other than that you really have close access to just about everything. I never pay to park anywhere, people are usually friendly and I rarely wait in line. I do think it is funny how some people (particularly from the east coast) believe that people in the midwest are somehow "behind". I met some people from New York on interviews and a couple of them actually believed me when I said we had only had cable TV in South Dakota for about 10 years! HAHA! We have the same cell phones, television options, high-speed internet services, cars, banks and stores as they do anywhere else. High school students in ND, SD, NE, WY and MT have among the highest scores on standardized tests in the entire country (ND is #1 on SAT and ACT). As far as avoiding like the plague? . . . many physicians love practicing in smaller areas. Physicians in the midwest make more than physicians in almost all areas of the country (they make slightly more in the deep south) and live in areas with a lower cost of living. This is most likely due to the paucity of HMOs--a wonderful thing in my opinion. Peoples' needs can be very different and many people are more than content to live in the midwest and wouldn't consider living in an overpopulated area. I am personally overjoyed that there are so many that feel as you do and will therefore stay far away.