So - highest paying specialties/subspecialties in NYC?

[NeedSomeAdviceGuy]

Just asking out of curiosity. I know specialties have regional differences but curious what yall think/know are the highest paying specialties/subspecialties (outside of surgery) in NYC. Hoping for categories of each so academic, hospital/in-patient, private practice.

I'm from NYC, go to school in NYC, plan to stay in NYC. Money isn't why I'm here, but I'm going to have 500k debt when I graduate with a low-income spouse, and I love practically every field and have the scores/prestige to enter anything so hoping for yalls input.


Thanks bois and gals <3

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[IMGASMD]

Easy. If you’re a good plastic surgeon. Or any other speciality that can afford to take no insurance.

 

[SweetBurger]

nsgy if you like operating in ur free time

 

[karayaa]

since you're asking for non-surgical, consider practices that have potential for private-practice cash-based payments. Derm/Psych for sure. Maybe concierge primary care? You'd have to work super hard in either field.
Most other medical fields are limited by insurance payors, or by the supply/demand that affect hospital system employees. I suspect that traditionally high-paying fields (GI, cards, heme/onc, etc) would have lower income in NYC, similar to any other big city, because there's lots of competition from other docs who want to live and practice there also, which limits the number of patients you can see.

 

[PhillyMed777]

Neurosurgery
Orthopedics (esp at HSS)

 

[NeedSomeAdviceGuy]

Easy. If you’re a good plastic surgeon. Or any other speciality that can afford to take no insurance.

nsgy if you like operating in ur free time

Neurosurgery
Orthopedics (esp at HSS)

I said non-surgical hehe

 

[IMGASMD]

I said non-surgical hehe

I said any speciality that’s cash only.

 

[NeedSomeAdviceGuy]

I said any speciality that’s cash only.

" that can afford to take no insurance. " means cash only?

And what specialties would those be?

 

[NeedSomeAdviceGuy]

I don't see how you can claim that you care about your $500,000 in loans and still desire to stay in NYC throughout residency training and beyond.

I mean it's an easy claim. I grew up here. My family is here. My friends are here. My spouse is here haha.

I lived in NYC all my life on ~11-13k a year. Being 500k in debt while being a physician isn't going to stop me from being able to live here.

but I forgot you want to stay in NYC and live in a box.

I mean I like living in NYC? My 1100 sqft apartment is more than enough. It's clear it ain't for you, but people are different man.

 

[Skindoc83]

The short answer is none. Even if you’re a cosmetic fill in the blank that doesn’t take insurance you’re a dime a dozen and there are a limited number of patients willing to pay out of pocket for whatever service you offer and there are a lot of docs competing for that patient. if you’re the top of your field you can make good money but that is a late career position. If you’re dead set on staying in NYC Pick whatever field you enjoy and be ready to continue to live like a student

 

[NeedSomeAdviceGuy]

The short answer is none. Even if you’re a cosmetic fill in the blank that doesn’t take insurance you’re a dime a dozen and there are a limited number of patients willing to pay out of pocket for whatever service you offer and there are a lot of docs competing for that patient. if you’re the top of your field you can make good money but that is a late career position. If you’re dead set on staying in NYC Pick whatever field you enjoy and be ready to continue to live like a student

I don't mind my life as a student, the only thing is seeing my classmates who have gotten to travel their whole lives and continue to do so as something I've never gotten to do. I assume I'd be able to start doing that in my life after graduation?

And to anyone who asks, no I have no intent on having children/starting a family.

 

[AnonymousDoctorGuyPerson]

I'm from NYC, go to school in NYC, plan to stay in NYC.

Idk the answer specialty wise, but definitely ignore the others about NYC. Clearly the earning potential in NYC is one of the lowest but there's a reason people still want to live there, as a NYC native myself I get you. I'd also be wary of heeding the advice of specialty pursuit by finance, mainly because I can only assume most of those on here grew up in decent income households (them yearly family vacation types) and have come to expect a certain lifestyle, one they'd lose in NYC. If you're from NYC and, considering your debt, more than likely not from one of those backgrounds you're gonna be relatively fine.

And specialty wise, outside maybe like Peds without a lot of extra work put in, you can easily tackle your debt and live comfortably in NYC as a physician. If you're single and living in NYC you can maximize the benefits of living in NYC as well as take vacations on a 70 to 80k salary. You can imagine your attending salary as everything above that going towards your loans.

 

[Yhwach]

SDN gets very anti NYC/big city. The truth is some of us like the city. We rather take that than live in a suburb or rural area. Everyone has different wants and desires.

 

[NITRAS]

SDN gets very anti NYC/big city. The truth is some of us like the city. We rather take that than live in a suburb or rural area. Everyone has different wants and desires.

No, lots of people like the big cities. Too many people. You can have it.

People make their own choices. Just don’t complain because your cost of living his high and your at the bottom of the pay scale because you were “forced” to live in XYZ city.

 

[AnonymousDoctorGuyPerson]

No, lots of people like the big cities. Too many people. You can have it.

People make their own choices. Just don’t complain because your cost of living his high and your at the bottom of the pay scale because you were “forced” to live in XYZ city.

No one is complaining or saying they're forced 🙂

 

[NeedSomeAdviceGuy]

No, lots of people like the big cities. Too many people. You can have it.

People make their own choices. Just don’t complain because your cost of living his high and your at the bottom of the pay scale because you were “forced” to live in XYZ city.

all the threads I see is people saying they wanna live in NYC because they're from there and love it, and the response is "eNJoy your shoEbox Fool!" - seems like most of the complaining comes from people who don't wanna live in NYC who, for whatever reason, hate the idea of others living choosing to live in NYC?

 

[NeedSomeAdviceGuy]

Work 1.5x in the midwest for a year and you'll make $500k in any specialty to pay down your loans then move back to NYC. You can even fly to NYC and back in your free time and still come out ahead.

That's not a bad idea actually, thanks!

 

[Chibucks15]

It’s not “anti NYC”. It’s more that if your 500k in debt you aren’t entitled to live in NYC where COL is insane. I understand you grew up there and your life is there. But you could just as easily live semi close and go into the city whenever so you can pay off loans.

the thing that drives people crazy here is when people will literally not accept that they can’t live in NYC/LA due to their crazy debt/specialty. Sometimes it just ain’t in the cards. Go work somewhere for a while to make money, ive heard upstate NY pays well, then move back once you make a dent in the loan burden cuz otherwise you’ll never retire in NYC

 

[Tenk]

Work 1.5x in the midwest for a year and you'll make $500k in any specialty to pay down your loans then move back to NYC. You can even fly to NYC and back in your free time and still come out ahead.

There are these things called taxes btw.

 

[NeedSomeAdviceGuy]

you could just as easily live semi close and go into the city whenever so you can pay off loans.

the thing that drives people crazy here is when people will literally not accept that they can’t live in NYC/LA due to their crazy debt/specialty. Sometimes it just ain’t in the cards. Go work somewhere for a while to make money, ive heard upstate NY pays well, then move back once you make a dent in the loan burden cuz otherwise you’ll never retire in NYC

People live in NYC with 35k salaries. 500k debt or not, my equivalent life will not be less than 35k. Nothing to do with "entitled" - some of us are fine with living like we are now going forward.

Would I have to live worse than I do now? Idts

Man Im just asking what's the highest paying specialty in NYC that isn't surgical and pretty much none of yall wanted to answer that and just be mad I wanna stay in NYC and had to pay for undergrad/grad/med school out of pocket

 

[odyssey2]

People live in NYC with 35k salaries. 500k debt or not, my equivalent life will not be less than 35k. Nothing to do with "entitled" - some of us are fine with living like we are now going forward.

Would I have to live worse than I do now? Idts

Man Im just asking what's the highest paying specialty in NYC that isn't surgical and pretty much none of yall wanted to answer that and just be mad I wanna stay in NYC and had to pay for undergrad/grad/med school out of pocket

You'll make plenty of money as any kind of doctor to live decently well in NYC, even with debt. You'd make more in Columbus Ohio and be able to get a bigger house, but Columbus ain't NYC and you and I both know it. It's fine to want what you want and maximize the benefits, plenty of people live happily in big cities on less than 100k.

 

[NeedSomeAdviceGuy]

Lol at thinking those pointing out the foolishness of remaining in NYC with half a million dollars in debt are anti-city. Think this sentiment is just SDN? Post your question on the WCI forum for an actual reality check.

Its NYC, plenty do it 🙂


Also, once again, not unrealistic when your income is 200k+

When your salary is half your debt it's FAR more than reasonable. Hell, my parent's debt was like 15x their income and they lived here fine enough.

IBR for 10 years, woopty doo. The question isn't about my debt.

 

[AMEHigh]

It’s not “anti NYC”. It’s more that if your 500k in debt you aren’t entitled to live in NYC where COL is insane. I understand you grew up there and your life is there. But you could just as easily live semi close and go into the city whenever so you can pay off loans.

the thing that drives people crazy here is when people will literally not accept that they can’t live in NYC/LA due to their crazy debt/specialty. Sometimes it just ain’t in the cards. Go work somewhere for a while to make money, ive heard upstate NY pays well, then move back once you make a dent in the loan burden cuz otherwise you’ll never retire in NYC

Huh?
This is so weird.
There are plenty of physicians that live in NYC, spoiler alert, even many that make primary care salaries. And there are also even physicians that retire!
The advice to just move somewhere for a couple of years and then move isn’t always realistic.
If someone wants to live in nyc, or SF or London or anywhere else with a high cost of living, who cares?
One certainly doesn’t have to live like a student eating ramen while living in nyc. Also, for some people buying a big house with land, having a car, really are not priorities.

 

[radsisrad]

Derm. Then again, my position is generally that anyone who has the opportunity to match derm, yet does not, has made a gigantic mistake.

 

[InternistDO]

It's best to ignore the normal SDN commentary about New York, which at this point I can recite from memory. You should however, accept the basic premise of what people are saying, which is that you as a general rule will make less as a physician in NYC than you will in other, cheaper places.

To actually answer your question, have you done 3rd year yet? The differences in lifetime compensation between fields (especially non-surgical ones, and especially in NYC where salaries are squeezed more) is not as crazy big as people think, so picking a field purely based on money may not be the wisest choice if you have other priorities, whether it be work/life balance, enjoyment of the field, research, whatever.

That being said, NYC still has a psych shortage so cash only psych wouldn't be unreasonable for a high earning position. Derm, obviously, though I don't know how the job market is. Adult primary care makes 180-250/year in the city from the offers I've seen, with 180 being NYC Health and Hospitals clinics and 250 being some private practice offices. The last I heard about EM was that the community programs were paying close to 300/year but with the increase in EM spots that may be dropping. My very limited understanding of the cards/pulm/GI specialties is that they make around-ish what EM makes in the city but don't quote me on that. Anesthesia is close to that too. I'd avoid peds if your objective is to make money.

And as with anywhere, academic and county/city jobs will pay less than private practice but PP will disqualify you from PSLF if that's a goal of yours.

 

[radsisrad]

based on your name -- you wouldn't even take rads over derm if given opportunity at both?

No. I'd rather have the freedom to hang my own shingle and charge cash. Plus, derm training is shorter and derm has a better outlook as AI goes.

 

[NeedSomeAdviceGuy]

based on your name -- you wouldn't even take rads over derm if given opportunity at both?

Also, paying off debt in NYC = bad. But surviving off doctor salary in NYC = easy. You won't be rolling in Bentleys like you could in rural midwest, and you won't be living the private equity life, but you can carve yourself a quality living once you're debt-free in any specialty

I grew up in Queens so I don't even got a license so ain't no bentleys on the menu for me lmaoo

But yeah that's a good point, I'll look into "returning" to NYC.

 

[NeedSomeAdviceGuy]

No. I'd rather have the freedom to hang my own shingle and charge cash. Plus, derm training is shorter and derm has a better outlook as AI goes.

OOC - do you actively enjoy a derm practice or are you just interested in income-return? I personally hate derm myself.

 

[NITRAS]

Its NYC, plenty do it 🙂


Also, once again, not unrealistic when your income is 200k+

When your salary is half your debt it's FAR more than reasonable. Hell, my parent's debt was like 15x their income and they lived here fine enough.

IBR for 10 years, woopty doo. The question isn't about my debt.

The only reason you aren’t concerned about the debt is that your planning on being subsidized by the government. Depending on the government is generally a bad idea. The government is a huge bureaucracy staffed by people who want easy jobs, funded by taxpayers who can be quite fickle.

Debt loads really should effect your life choices. To ignore it is naive.

If you want to live in NYC, in SF, and whatever. . . Fine.

But really saying that having a debt load twice your income is a good idea . . . . Is unwise at best.

 

[NeedSomeAdviceGuy]

The only reason you aren’t concerned about the debt is that your planning on being subsidized by the government. Depending on the government is generally a bad idea. The government is a huge bureaucracy staffed by people who want easy jobs, funded by taxpayers who can be quite fickle.

Debt loads really should effect your life choices. To ignore it is naive.

If you want to live in NYC, in SF, and whatever. . . Fine.

But really saying that having a debt load twice your income is a good idea . . . . Is unwise at best.

Didnt say it was a good idea, just saying it's not unreasonable as yall make it sound. I grew up surrounded by people whose debt-to-income ratio was far more egregious than my own and I'm okay with that sacrifice to live a life surrounded by the community I love (and am training to specifically serve), my friends, my family, etc.. Im also used to working double time, which I certainly plan to continue doing after residency.

Pretty simple really, ain't all about them dollar bills yo.

 

[Lucca]

$$/hrs I dont think anyone can touch derm. Psych is probably close if you can find the right PP setup.

That said, the MGMA data has the highest non-surgical eat coast PP specialty as interventional cards or cards electrophysiology.

 

[NeedSomeAdviceGuy]

$$/hrs I dont think anyone can touch derm. Psych is probably close if you can find the right PP setup.

That said, the MGMA data has the highest non-surgical eat coast PP specialty as interventional cards or cards electrophysiology.

Thanks for answering my question <3

IV Cards is on my radar so good to know!

 

[FindersFee5]

Pretty simple really, ain't all about them dollar bills yo.

Do you maybe see how people got that impression, though, when you title your thread "So - highest paying specialties/subspecialties"?

 

[FindersFee5]

Thanks for answering my question <3

IV Cards is on my radar so good to know!

IV cards may not be the best for somebody with your debt load. It's an 8 year post-graduate training route, and if you want to do that training in NYC too, your debt will likely be ballooning during that time.

 

[NeedSomeAdviceGuy]

Do you maybe see how people got that impression, though, when you title your thread "So - highest paying specialties/subspecialties"?

They could read the rest of the post though 🙂

You know, the whole " I'm from NYC, go to school in NYC, plan to stay in NYC. Money isn't why I'm here, but I'm going to have 500k debt when I graduate with a low-income spouse, and I love practically every field and have the scores/prestige to enter anything so hoping for yalls input. "

People really went off to ignore the NYC part of the criteria.

 

[NeedSomeAdviceGuy]

IV cards may not be the best for somebody with your debt load. It's an 8 year post-graduate training route, and if you want to do that training in NYC too, your debt will likely be ballooning during that time.

Good point. Atm I am leaning towards straight hospitalist, love the flexibility and scope. Though I have interesting in A&I/Cards/HemeOnc.

Peds as well but am taking that off the table.

 

[Tenk]

I am aware. This is not a genius idea. I didn't say "pay off all of your loans" - post tax $350k OP could pay down $300k then move to NYC and enjoy the rest of his career with whatever amount he has left. There was a psych resident on SDN a while back who wrote a detailed essay on how he paid down some $400k loans as a resident. He essentially moonlighted during PGY2/3 in the boonies for $5k/weekend and had no life but was debt free after residency.

We all know how interest works (even if refinanced to 3-4% it's still a lot with a large amount like 400k). Maybe it's because I've never lived in a big city so I don't know what I'm missing out on (I've visited a dozen major cities and enjoyed my time there but never felt the urge to live there, but that's just me)

Personally, I'd rather bust my ass off for 2 years in the midwest (doesn't have to be the boonies) as an attending (or moonlighting during residency if the program allows it) and pay off everything to then have the financial freedom to invest and begin building a passive income stream early on in one's career to allow for retirement after 20-30 years. Rather than living In a big city from day one making $200k post-tax, living off $100k and paying down the loans over 10 years (and being at net $0 wealth).

Where I live all (mid-sized midwest city) doctors are swimming in money (75th%ile + salaries) and are able to own multiple homes, take many vacations, drive the nicest cars (and yes we have Michelin restaurants and high-end boutiques here).

You don’t make $300k from $350k pretax. Your effective federal + FICA at that level is going to be almost 30% if you’re single. That’s not including state taxes, cost of living and whatever else.

As someone who paid off ~$400k in loans in 4 years, I’m not disagreeing with the principles of what you’re saying. Your math is off though and it’s a bit harder than what you’re saying is all.

 

[DoctwoB]

All the people saying cash pay things, you’re mistaking salary for ceiling. A successful high end cash pay cosmetic clinic could rake in dough. But most won’t. most will probably lose money and go out of business or keep the lights on by just seeing regular insured patients. And whether you will succeed or not depends 0% on your ability to practice medicine and 100% on your business Savy and marketing.

 

[You shall know the Truth]

Just asking out of curiosity. I know specialties have regional differences but curious what yall think/know are the highest paying specialties/subspecialties (outside of surgery) in NYC. Hoping for categories of each so academic, hospital/in-patient, private practice.

I'm from NYC, go to school in NYC, plan to stay in NYC. Money isn't why I'm here, but I'm going to have 500k debt when I graduate with a low-income spouse, and I love practically every field and have the scores/prestige to enter anything so hoping for yalls input.


Thanks bois and gals <3

MOB doctor, I heard they make a killing.

 

[radsisrad]

OOC - do you actively enjoy a derm practice or are you just interested in income-return? I personally hate derm myself.

I'm in radiology, not derm. But, like you, I could have had my pick of fields as a med student. All of medicine gets boring, mundane, and distracting from the important things in life (children, travel, concerts, etc.) once you're 10 years in. Choose a field in which you can be your own boss while being in such perennially high demand that you can make a practice work even if you are the MBA class case study of what not to do in a business. Choose derm.

 

[7331poas]

I'm in radiology, not derm. But, like you, I could have had my pick of fields as a med student. All of medicine gets boring, mundane, and distracting from the important things in life (children, travel, concerts, etc.) once you're 10 years in. Choose a field in which you can be your own boss while being in such perennially high demand that you can make a practice work even if you are the MBA class case study of what not to do in a business. Choose derm.

Do you advise against picking radiology in general?

 

[Tenk]

$350k post-tax from 500K (my earlier comment). OP seems motivated to make as much money as possible. This is easily achievable by working overtime as an attending in the midwest. Moonlighting in certain specialties in the boonies (psych e.g.) in the boonies can also make an extra $10-$15k/month

That makes more sense but it’s still ridiculously hard. I’ve made almost $500k in EM and that entire year sucked and I actually like where I work. Making that much in less lucrative fields would be game over. It’s easy to say “yeah just go into some random place and work every day for an entire year and live in a trailer and eat top ramen.” It’s another thing to actually go and do it. There’s a reason those jobs pay more: they suck. It’s why very few people, if any, actually do this.

A better plan is to just find a job you like in an area you love, start planning for retirement, live an enjoyable but not completely lavish lifestyle and pay down debt. This way you’ll be happy and create good spending habits. This is just harder in cities so it’s sometimes better to live outside them.

 

[NeedSomeAdviceGuy]

Lol at thinking those pointing out the foolishness of remaining in NYC with half a million dollars in debt are anti-city. Think this sentiment is just SDN? Post your question on the WCI forum for an actual reality check.

Those same people told me not to attend med school because of my undergrad/grad debt so lmao nty

 

[radsisrad]

Do you advise against picking radiology in general?

No. Rads is cush and easy money. But for students who have the scores and academic support: choose derm. Unless you want to live somewhere rural; there, you won't have the volume to make derm lurative, but can practice telerads and make an easy 450k.

 

[odyssey2]

No. Rads is cush and easy money. But for students who have the scores and academic support: choose derm. Unless you want to live somewhere rural; there, you won't have the volume to make derm lurative, but can practice telerads and make an easy 450k.

Why is derm preferable? Is it that much more lucrative?

 

[CaptainZeki]

No. Rads is cush and easy money. But for students who have the scores and academic support: choose derm. Unless you want to live somewhere rural; there, you won't have the volume to make derm lurative, but can practice telerads and make an easy 450k.

What is telerad? Is it radiologist but the telehealth aspect?

 

[Dral]

I did Derm residency in NYC. Several of the folks that graduated from my program stayed in NYC and opened up shop. The common thread with all of them: They are all relentless self promoters (Social media presence, professional websites, advising/doing interviews with national magazines, rubbing elbows with famous people, etc).

 

[Kuratz]

Disagree about choosing Derm over Rads. You have to be able to tolerate the workflow of either and it's not like Rads pays poorly. Choose something you can envision doing every week for a long time.

But to OP: Whereas jobs in the Midwest/South/Suburban coast routinely pay $6-700k as partner for Rads (and with ~10 weeks vacation), it is probably closer to $400k in NYC. I'd imagine the differential is similar for other sub-specialties but I can't say with certainty.

$400k in NYC is ~$232k post-tax. Subtract ~80k if paying loans over 10 years and you get $152k to live on ($12,600/mo).
Put away $3k per month to be able to retire in early 60s and you get ~$9500 for rent/mortgage and all expenses. Doable if that's what your priorities are. Personally I'd rather live in another city like even suburban Chicago, make a ****load more $$ with way lower COL, and visit my desired area multiple times per year. To each their own.

I think living on anything less than $300k in somewhere like NY or SF would be very tough if you have $500k of loans.

 

[Dral]

Disagree about choosing Derm over Rads. You have to be able to tolerate the workflow of either and it's not like Rads pays poorly. Choose something you can envision doing every week for a long time.

But to OP: Whereas jobs in the Midwest/South/Suburban coast routinely pay $6-700k as partner for Rads (and with ~10 weeks vacation), it is probably closer to $400k in NYC. I'd imagine the differential is similar for other sub-specialties but I can't say with certainty.

$400k in NYC is ~$232k post-tax. Subtract ~80k if paying loans over 10 years and you get $152k to live on ($12,600/mo).
Put away $3k per month to be able to retire in early 60s and you get ~$9500 for rent/mortgage and all expenses. Doable if that's what your priorities are. Personally I'd rather live in another city like even suburban Chicago, make a ****load more $$ with way lower COL, and visit my desired area multiple times per year. To each their own.

I think living on anything less than $300k in somewhere like NY or SF would be very tough if you have $500k of loans.

In terms of specialty, that’s true. Both Derm and Rads (at least what I experienced when I shadowed radiologists back in med school) are typically fast paced and if one has zero interest in the day to day of their specialty, they’ll be miserable. I don’t want to start a Derm vs Rads back and forth since that is for the OP to decide (sounds like they’re not keen on Derm), but another thing to consider is if one decides to subspecialize. In a lot of the non urban places, you can get a good mix of what you want to do, but that’s harder in a large urban market. For instance, I would LOVE to have stayed in NYC...I loved living there. I fellowed in dermpath. If I worked in NYC I’d probably be paid half of what I currently earn, but more importantly, I would likely not be able to get the mix of DP versus Derm that would make me happy. This is of course specialty/sub specialty dependent in general. Someone who went IM and did heme/onc could probably only do heme/onc without general IM for example.

Good general advice from one of the attendings where I did residency: When you start out you want a solid 2 out of 3 of the following:
1. Geographic location where you want to be
2. Earning the amount you want to get paid
3. Doing pretty much exactly what you want to do

Those can change over time. OP, for you, you’ll be checking off number 1. As I’m alluding to in my post, you may not quite get there in 2 and 3. However, you’ll make it work if #1 is very important to you.

 

[Sleepingdoc]

Easy. If you’re a good plastic surgeon. Or any other speciality that can afford to take no insurance.

Honestly its getting to a point where accepting no insurance for any specialty may be the way to go in the future to make the time worth it... some of the reimbursement that i see is a joke...