Why I like low cost of living areas

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As Doze would put it "it isn't how much you earn but how much you keep that will determine your wealth going forward." A few absurd areas to avoid for me include: NYC, SF, LA, SD, Seattle, Chicago, Washington D.C area, etc.

I'm not criticizing those who choose to live in those areas but rather pointing out you need to earn a lot more money based on the cost of living for those municipalities.
 
 
This list is BS. It only looks at metropolitan areas. Look at places like Telluride, Aspen, etc.
But of course, you must pay to live in paradise. If everyone wants to live there then it's gonna cost you an arm and a leg.
For me, it's about day to day quality of life. I couldn't pay the SF prices comfortably. But luckily that scene drives me nuts. As does most big cities. I need to be able to enjoy my outdoors right from my front door.

Btw, I could live in a garage and **** in a bucket, no problem.

My wife, now that's another story. But she isn't far off either.
 
I enjoy the combination of living in a very low cost area and earning a very high salary. Unfortunately for many in our line of business, the high cost of living areas also come with lower salaries than you can earn in other "less desirable" areas.
 
To each his own. I live in one of those high cost areas that you listed and I wouldn't have it any other way. Do I have a yacht and a six-car garage? No. I have a nice but modest house that I can raise an entire family in, a couple of functional cars that get me from point A to point B safely, and we limit our vacations and unnecessary spending. But I also live in a city that people would die to vacation in for a week out of the year, I'm a stones throw away from any activity you could possibly want to do, and I'm still on track to retire at a decent age.

Even if you offered me a salary quadruple what I'm making now and the ability to retire 10 years earlier, I would politely decline if it meant needing to drive for 30 minutes to get to the nearest grocery store.
 
Urzuz said:
To each his own. I live in one of those high cost areas that you listed and I wouldn't have it any other way. Do I have a yacht and a six-car garage? No. I have a nice but modest house that I can raise an entire family in, a couple of functional cars that get me from point A to point B safely, and we limit our vacations and unnecessary spending. But I also live in a city that people would die to vacation in for a week out of the year, I'm a stones throw away from any activity you could possibly want to do, and I'm still on track to retire at a decent age.

Even if you offered me a salary quadruple what I'm making now and the ability to retire 10 years earlier, I would politely decline if it meant needing to drive for 30 minutes to get to the nearest grocery store.
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Divide that 10 years earlier retirement by 30 min. Hell, divide it by an hour for round trip. Figure out how many times you could go to that store and buy groceries.
 
It all depends on the person. Some people will get down right bored as "F" in a small town/small-ish city while the hustle and bustle of city life may stress another out. I think there's a perfect middle ground but even those places are getting expensive as people "figure out the game". The fact that Portand is on that list proves the point.

I may even argue, with little facts to back it up, that there are some politics behind it too. I bet Blade can find some stuff. But notice that most of those 'high cost of living' and "desireable" places to live are in very blue states (except Fl and AK) with probably blue state taxes. Im shooting from the hip and like I said I haven't researched it but I bet there's something there. It's no coincidence that low cost, doctor friendly salary states happen to be in the south and midwest.

And to put it more simple, many of those cities are where gentrification and the return to urban living for many non physician fields (tech, finance, etc) are happening quickly. I won't be suprised to see Austin on that list soon.
 
BLADEMDA said:
As Doze would put it "it isn't how much you earn but how much you keep that will determine your wealth going forward." A few absurd areas to avoid for me include: NYC, SF, LA, SD, Seattle, Chicago, Washington D.C area, etc.

I'm not criticizing those who choose to live in those areas but rather pointing out you need to earn a lot more money based on the cost of living for those municipalities.
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ahahaha
BLADEMDA said:
Ranking City Price Index *
1st New York City (United States) 290
2nd San Francisco, California (United States) 278
3rd Washington D.C. (United States) 270
4th Honolulu, Hawaii (United States) 245
5th San Jose, California (United States) 238
6th Boston, Massachusetts (United States) 233
7th Los Angeles, California (United States) 225
8th Oakland, California (United States) 223
9th Seattle, Washington (United States) 219
10th San Diego, California (United States) 216
11th Philadelphia, Pennsylvania (United States) 216
12th Chicago, Illinois (United States) 214
13th Denver, Colorado (United States) 208
14th Miami, Florida (United States) 206
15th Anchorage, Alaska (United States) 205
16th Portland, Oregon (United States) 204


https://www.expatistan.com/cost-of-living/index/north-america
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if you know of a cheap place to live with a ton of theatre, museums & live music, a killer food scene and lots of young, secular, leftist, single women, i am so all ears.
 
sudaaaamnadex said:
ahahaha



if you know of a cheap place to live with a ton of theatre, museums & live music, a killer food scene and lots of young, secular, leftist, single women, i am so all ears.
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Austin is probably the closest you'll get on that list with decent weather. Honestly, once you're outside the Top 10 of that list it's mostly "per se". You can actually still find a decent priced home in places like Chicago and Portland, but as others have said, you just may not have a high priced job. Now they'll pay you 600k to work in farmland California.....but it's farmalnd CA.
 
Twiggidy said:
Austin is probably the closest you'll get on that list with decent weather. Honestly, once you're outside the Top 10 of that list it's mostly "per se". You can actually still find a decent priced home in places like Chicago and Portland, but as others have said, you just may not have a high priced job. Now they'll pay you 600k to work in farmland California.....but it's farmalnd CA.
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btw, i was laughing because my rank list is pretty much the list Blade quoted. Austin is a great city, although its infrastructure is about 10 years behind its population, and, for me, Texas is unlivable from March through October. I have great jackets and rain gear, but can't stand soaking through my shirt on the way out to my car. Also, no residency program there (yet).

Glad to hear about Portland - there's a reason I have OHSU ranked #1
 
Article is typical click bait. I live in the SF Bay Area. Know multiple people working in tech world, including some of my relatives. Trust me, they ain't struggling at all. Quite the opposite. Don't trust everything you read
 
Noyac said:
This list is BS. It only looks at metropolitan areas. Look at places like Telluride, Aspen, etc.
But of course, you must pay to live in paradise. If everyone wants to live there then it's gonna cost you an arm and a leg.
For me, it's about day to day quality of life. I couldn't pay the SF prices comfortably. But luckily that scene drives me nuts. As does most big cities. I need to be able to enjoy my outdoors right from my front door.

Btw, I could live in a garage and **** in a bucket, no problem.

My wife, now that's another story. But she isn't far off either.
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Yup, yup. 👍

Well... except for the garage bucket part- I def. would have a problem with that scene-->especially when the flies move in on my space. :stop::doctor:
 
sudaaaamnadex said:
ahahaha

if you know of a cheap place to live with a ton of theatre, museums & live music, a killer food scene and lots of young, secular, leftist, single women, i am so all ears.
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New Orleans.

It has its own set of problems but it offers what you listed.
 
Twiggidy said:
Austin is probably the closest you'll get on that list with decent weather. Honestly, once you're outside the Top 10 of that list it's mostly "per se". You can actually still find a decent priced home in places like Chicago and Portland, but as others have said, you just may not have a high priced job. Now they'll pay you 600k to work in farmland California.....but it's farmalnd CA.
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I would love, love to make 600k working in farmland California. Problem is, half of that would be Taxes in CA.
 
BFE is a road to financial freedom. Especially during these times.

My advice: Make bank in BFE while the sun is shinning and move to your dream location after. Makes things a lot easier.... but you loose precious years in exchange.

You have to pay the piper one way or the other (although great payor mix does exist in vacationland).
 
Life is too short to live somewhere you'd be unhappy just so you can watch your retirement fund grow. If you love NYC and don't mind paying $1 million for a 1 bedroom condo then go for it. Just understand the trade offs.

It's interesting that I think of Philadelphia as a pretty affordable city after my experiences with other east coast cities. How is Anchorage so high on that list?
 
sevoflurane said:
My advice: Make bank in BFE while the sun is shinning and move to your dream location after. Makes things a lot easier.... but you loose precious years in exchange.
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That's a boomer mentality.

Millennials want to enjoy the ride, not just the end point.

Times change.
 
BLADEMDA said:
As Doze would put it "it isn't how much you earn but how much you keep that will determine your wealth going forward." A few absurd areas to avoid for me include: NYC, SF, LA, SD, Seattle, Chicago, Washington D.C area, etc.

I'm not criticizing those who choose to live in those areas but rather pointing out you need to earn a lot more money based on the cost of living for those municipalities.
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I don't think it's that bad. I grew up in the burbs about 25 minutes from downtown Chicago (if no traffic). Despite being so close to the city, it's a quiet suburb that's surrounded by forest preserves, golf courses, and even a few horse stables. Growing up some of my friends parents made 200k+ while others worked for ~17/hr. You can buy a nice 4 bedroom house here for ~500k. Rent for a 1 bdrm apt is like 1k. I don't think those numbers crazy high.
 
Living in BFE has its issues. Those places can be cultural wastelands, even moreso if you're a minority.

Plus plenty of the suburbs of these bigger cities are reasonably affordable on a physicians salary.

At the end of the day, location is king when choosing a job for the majority of physicians.
 
GravelRider said:
Life is too short to live somewhere you'd be unhappy just so you can watch your retirement fund grow. If you love NYC and don't mind paying $1 million for a 1 bedroom condo then go for it. Just understand the trade offs.

It's interesting that I think of Philadelphia as a pretty affordable city after my experiences with other east coast cities. How is Anchorage so high on that list?
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I lived in Philly for a year. I think it would be a fantastic place to live if only they fixed their malpractice system (and traffic).

My guess about Anchorage is that nobody moves there unless they know that's the kind of place they like. So it's not unexpected that most of the inhabitants are happy there.
 
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urge said:
That's a boomer mentality.

Millennials want to enjoy the ride, not just the end point.

Times change.
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Don't put "us" in categories bro!

But seriously, I'm doing this. I just took an incredible job offer in a larger out-of-the-way city despite not loving the climate and lack of hobbies there. Given the $$$ and practice style, it was hard to say no. If/When everything falls apart in the field and there is little separating this job from those in more desirable areas, I can always move.
 
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sudaaaamnadex said:
if you know of a cheap place to live with a ton of theatre, museums & live music, a killer food scene and lots of young, secular, leftist, single women, i am so all ears.
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That sounds like something someone looks for in a place to live while in their 20s. Some of those things become far less important for people in their laters 30s, 40s, and 50s. I mean if you have a family, you probably want to spend as much time with them as you can after work. Personally my Monday morning to Friday afternoon life (plus whatever nights and weekends I work) would be identical in San Francisco, Manhattan, or somewhere like Des Moines or Mobile. Wake up, go to work, come home to eat dinner with family and play with kids. Now on weekends there tends to be more time/inclination to get out and do things which is why I personally live within an hour drive of a major metro area so I can still have those opportunities. But cutting my pay in half and upping my cost of living just to live there? No thanks. I could probably retire at about age 50 with an equivalent nest egg to age 65 if I lived there. But that's just me.
 
FFP said:
And don't we become slaves to that king, instead of being free in BFE?
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To an extent but If you or your partner don't like the area, then even the best job in the world is not going to work out. Seen this happen time and time again with friends.

Main thing is different priorities. Dollars are fine but certain things come at a premium : 300+ days of sun, diverse culture/ethnic population, access to major airports, easy access to the mountain/beaches . Those are all things I guess I'm a slave to but am more than happy to pay a premium for (and I have in my job search)
 
I'll say this. If you do choose a major cityh to live in do your best to buy as much home as you can afford because that will become your retirement next egg. Keep it in good shape, upgrade it when possible, and hope future presidents dont mess with capital gains tax.
 
Twiggidy said:
I'll say this. If you do choose a major cityh to live in do your best to buy as much home as you can afford because that will become your retirement next egg. Keep it in good shape, upgrade it when possible, and hope future presidents dont mess with capital gains tax.
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Wow, that's potentially horrendous advice. "As much as you can afford" means different things to different people I guess but if buying such a house means not maxing out retirement savings, having an emergency fund, good insurance, etc, then that is dangerous. Having a house take the place of retirement contributions is crazy if that is what you're implying.

Talk about all your eggs in one basket. Might have worked in Bay Area in past but I certainly wouldn't risk my retirment on such a gamble.
 
FFP said:
And don't we become slaves to that king, instead of being free in BFE?
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This is so very true.

In BFE administrators are worried about "Physician Retention" especially if you are good at what you do.

It's the opposite when there is a line out the door waiting for a position to free up.
 
anonperson said:
To an extent but If you or your partner don't like the area, then even the best job in the world is not going to work out. Seen this happen time and time again with friends.

Main thing is different priorities. Dollars are fine but certain things come at a premium : 300+ days of sun, diverse culture/ethnic population, access to major airports, easy access to the mountain/beaches . Those are all things I guess I'm a slave to but am more than happy to pay a premium for (and I have in my job search)
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They are all nice but worthless, if the job sucks. In the end, besides your bed, the job is where you'll spend most of your life. And the average job in BFE is much better than the one in popular areas.

I did my fellowship in a more remote place than where I am now, and it was my happiest year in the US, as some have noticed even on the forum. My family would not be happy there, so I came back to the usual large metropolitan area crap. Unless one already lives in the place where one would like to retire, semi-BFE (2-3 hours from the closest large city) may be a very good choice.
 
Mman said:
That sounds like something someone looks for in a place to live while in their 20s. Some of those things become far less important for people in their laters 30s, 40s, and 50s. I mean if you have a family, you probably want to spend as much time with them as you can after work. Personally my Monday morning to Friday afternoon life (plus whatever nights and weekends I work) would be identical in San Francisco, Manhattan, or somewhere like Des Moines or Mobile. Wake up, go to work, come home to eat dinner with family and play with kids. Now on weekends there tends to be more time/inclination to get out and do things which is why I personally live within an hour drive of a major metro area so I can still have those opportunities. But cutting my pay in half and upping my cost of living just to live there? No thanks. I could probably retire at about age 50 with an equivalent nest egg to age 65 if I lived there. But that's just me.
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It comes down to what you want out of your daily life.

We come in at 3pm when we are on first call.
I can be at the local ski resort that gets 600" of powder and be knee deep in that stuff until about 2:30pm before taking care of my first patient of the day.

Likewise, during the summer I can have an epic 4 hour mountain bike ride in some of the most beautiful forests in the country b4 coming in to work.

I literally can ride out my garage and connect to a trail across the street- which makes afternoon rides easy and a breeze.

During the summer I can be on a boat on a gorgeous lake and enjoy 4 hours of play time after I get off work.

But I get your point.

It's all personal preference and what you are willing to sacrifice for the hear and now.

I've been in both practices and I could never go back.
 
sevoflurane said:
It comes down to what you want out of your daily life.

We come in at 3pm when we are on first call.
I can be at the local ski resort that gets 600" of powder and be knee deep in that stuff until about 2:30pm before taking care of my first patient of the day.

Likewise, during the summer I can have an epic 4 hour mountain bike ride in some of the most beautiful forests in the country b4 coming in to work.

I literally can ride out my garage and connect to a trail across the street- which makes afternoon rides easy and a breeze.

During the summer I can be on a boat on a gorgeous lake and enjoy 4 hours of play time after I get off work.

But I get your point.

It's all personal preference and what you are willing to sacrifice for the hear and now.

I've been in both practices and I could never go back.
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You've just described my future I believe...
 
sevoflurane said:
It comes down to what you want out of your daily life.

We come in at 3pm when we are on first call.
I can be at the local ski resort that gets 600" of powder and be knee deep in that stuff until about 2:30pm before taking care of my first patient of the day.

Likewise, during the summer I can have an epic 4 hour mountain bike ride in some of the most beautiful forests in the country b4 coming in to work.

I literally can ride out my garage and connect to a trail across the street- which makes afternoon rides easy and a breeze.

During the summer I can be on a boat on a gorgeous lake and enjoy 4 hours of play time after I get off work.

But I get your point.

It's all personal preference and what you are willing to sacrifice for the hear and now.

I've been in both practices and I could never go back.
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You only have so much time on this planet, and you only have so many things you can control. Figure out what really makes you happy, whether that's waking up to rural views outside your front door, living in metropolis and eating at the latest trendy food truck everyday, working 80hrs/wk and watching your bank account swell, or sitting and watching your kid's little league game. Just don't be an idiot with your money, but also realize there's no guarantee you'll be around to enjoy that huge nested you've slaved away putting together for the last 20yrs. If you're not happy now, then do something about it. I think Ethan Hawke put it best:

 
Lurch said:
Wow, that's potentially horrendous advice. "As much as you can afford" means different things to different people I guess but if buying such a house means not maxing out retirement savings, having an emergency fund, good insurance, etc, then that is dangerous. Having a house take the place of retirement contributions is crazy if that is what you're implying.

Talk about all your eggs in one basket. Might have worked in Bay Area in past but I certainly wouldn't risk my retirment on such a gamble.
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No one is saying to buy a house instead of retirement contributions, and in general you should not view the house you live in as an investment. However, real estate in the areas mentioned on that list held their value much better during the market crash than those in the sun belt and Midwest. I can tell you that when my parents are ready to retire, they will have gained a lot of wealth from the house they bought 30 years ago in a top 10 metro area. They are not exactly trapped amongst skyscrapers either. Yes, taxes are high, but the public schools are top notch.
 
The list is deceiving because the difference between #1-3 (or 1-5) versus if you go halfway or 2/3 down the list is night and day. Living in Manhattan or the Bay area as a doctor is silly since your salary is half or one-third and your living expenses 2-3 times more, whereas you can get a very similar cultural experiences in most "top 25" US cities without moving to BFE. It makes sense if you are an i-banker or tech entrepreneur because those may be the only places you can get that type of job.

Comparing the tradeoffs for money vs culture in San Fran vs places you have to drive 30 minutes to the nearest grocery store is ridiculous. I've lived in several of the top 5 expensive cities on that list and honestly the culture and food opportunities are not that different in many other large metro areas (that pay 2-3x more with less traffic).


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GravelRider said:
No one is saying to buy a house instead of retirement contributions, and in general you should not view the house you live in as an investment. However, real estate in the areas mentioned on that list held their value much better during the market crash than those in the sun belt and Midwest. I can tell you that when my parents are ready to retire, they will have gained a lot of wealth from the house they bought 30 years ago in a top 10 metro area. They are not exactly trapped amongst skyscrapers either. Yes, taxes are high, but the public schools are top notch.
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I don't know what he is saying. "Buying as much as you can afford" should not be in lieu of retirement savings,etc. Sounds lime we agree on that. His post is ambiguous and needs clarification though. If you have a standard job in hcol area and save appropriately (per White Coat Investor) then what remains is what you have for a home purchase. There simply will not be room in budget to flex up on a home unless you are independently wealthy or do so at the expense of retirement.

That's great for your parents but past performance does not guarantee future results. That's why this thinking is dangerous.
 
doctalaughs said:
The list is deceiving because the difference between #1-3 (or 1-5) versus if you go halfway or 2/3 down the list is night and day. Living in Manhattan or the Bay area as a doctor is silly since your salary is half or one-third and your living expenses 2-3 times more, whereas you can get a very similar cultural experiences in most "top 25" US cities without moving to BFE. It makes sense if you are an i-banker or tech entrepreneur because those may be the only places you can get that type of job.

Comparing the tradeoffs for money vs culture in San Fran vs places you have to drive 30 minutes to the nearest grocery store is ridiculous. I've lived in several of the top 5 expensive cities on that list and honestly the culture and food opportunities are not that different in many other large metro areas (that pay 2-3x more with less traffic).


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Yah, all those docs living in those places are obviously so stupid. How come they haven't figured it all out like you? Makes no sense. Don't they realize that you know more about what makes them happy than they do themselves ?
 
Ezekiel2517 said:
Yah, all those docs living in those places are obviously so stupid. How come they haven't figured it all out like you? Makes no sense. Don't they realize that you know more about what makes them happy than they do themselves ?
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Never said they were stupid. Money doesn't matter at all to some people and good for them. Maybe there is family there, which would make sense to me. Maybe they think San Fran / Manhattan has so much better food/ culture than every other city in the USA that its worth making a third of the salary for the same job. If it really makes them happy why would I care?


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sevoflurane said:
It comes down to what you want out of your daily life.

We come in at 3pm when we are on first call.
I can be at the local ski resort that gets 600" of powder and be knee deep in that stuff until about 2:30pm before taking care of my first patient of the day.

Likewise, during the summer I can have an epic 4 hour mountain bike ride in some of the most beautiful forests in the country b4 coming in to work.

I literally can ride out my garage and connect to a trail across the street- which makes afternoon rides easy and a breeze.

During the summer I can be on a boat on a gorgeous lake and enjoy 4 hours of play time after I get off work.

But I get your point.

It's all personal preference and what you are willing to sacrifice for the hear and now.

I've been in both practices and I could never go back.
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I agree. I can be in the ocean in under an hour if I so desire, it's just that during the week I tend to have more family related priorities. Between 12 weeks vacation and most weekends off I still find plenty of free time to do all those fun things I so desire. But I agree you have to figure out what you want to do, work is work and the quality of your work life is an independent variable compared to location. Plenty of great hospitals to work in that aren't in the "best" cities in the country.
 
The best place to live is where you have the easiest access to the best beer. Actually, a blossoming craft beer scene has been shown as a marker of growing economic vitality and a sign that a city will continue to succeed.

Also, there is way more to NYC than midtown Manhattan and Times Square. There are plenty of affordable boroughs and suburbs of NYC, Boston, and DC. Maybe not as cheap as the Midwest, but certainly affordable.
 
sevoflurane said:
It comes down to what you want out of your daily life.

We come in at 3pm when we are on first call.
I can be at the local ski resort that gets 600" of powder and be knee deep in that stuff until about 2:30pm before taking care of my first patient of the day.

Likewise, during the summer I can have an epic 4 hour mountain bike ride in some of the most beautiful forests in the country b4 coming in to work.

I literally can ride out my garage and connect to a trail across the street- which makes afternoon rides easy and a breeze.

During the summer I can be on a boat on a gorgeous lake and enjoy 4 hours of play time after I get off work.

But I get your point.

It's all personal preference and what you are willing to sacrifice for the hear and now.

I've been in both practices and I could never go back.
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This sounds pretty amazing.

But here's a personal question and you obviously don't have to answer it- but do you have kids?
I live in one of the those cities on the list because of my kids. With me and my kids being non-white, I've always felt a diverse urban setting would be best for them.
 
sleepallday said:
This sounds pretty amazing.

But here's a personal question and you obviously don't have to answer it- but do you have kids?
I live in one of the those cities on the list because of my kids. With me and my kids being non-white, I've always felt a diverse urban setting would be best for them.
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One of my partners grew up in a small town in Georgia. He's Asian and his mom preferred that he date Asian girls. His reply, "But Mom, the only Asian girls in school are my sisters!"
 
nimbus said:
One of my partners grew up in a small town in Georgia. He's Asian and his mom preferred that he date Asian girls. His reply, "But Mom, the only Asian girls in school are my sisters!"
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Any relation to the Targaryens?
 
doctalaughs said:
The list is deceiving because the difference between #1-3 (or 1-5) versus if you go halfway or 2/3 down the list is night and day. Living in Manhattan or the Bay area as a doctor is silly since your salary is half or one-third and your living expenses 2-3 times more, whereas you can get a very similar cultural experiences in most "top 25" US cities without moving to BFE. It makes sense if you are an i-banker or tech entrepreneur because those may be the only places you can get that type of job.

Comparing the tradeoffs for money vs culture in San Fran vs places you have to drive 30 minutes to the nearest grocery store is ridiculous. I've lived in several of the top 5 expensive cities on that list and honestly the culture and food opportunities are not that different in many other large metro areas (that pay 2-3x more with less traffic).


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Depends on ethnic food. I can tell u the indian, Persian, Asian food are much better up north say in DC or Manhattan than in Miami or Dallas (both major population areas)

Culture much better up north.

Just sayin.

To each their own. In a perfect world. I be in Florida from October-March and be up north from March-October. There are benefits to living in each area.
 
doctalaughs said:
Comparing the tradeoffs for money vs culture in San Fran vs places you have to drive 30 minutes to the nearest grocery store is ridiculous. I've lived in several of the top 5 expensive cities on that list and honestly the culture and food opportunities are not that different in many other large metro areas (that pay 2-3x more with less traffic).


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I think you over exaggerate the pay differential. Some very well paying jobs are in these top cities. You'd have to be making well into 7 figures to be 2-3x. And it's possible to live and work in many of these cities with basically zero commute. The lifestyle can be fabulous if you like city life.
 
nimbus said:
I think you over exaggerate the pay differential. Some very well paying jobs are in these top cities. You'd have to be making well into 7 figures to be 2-3x. And it's possible to live and work in many of these cities with basically zero commute. The lifestyle can be fabulous if you like city life.
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I don't think so. Of course it depends on your specialty and which city. But I used to live in one of those cities at the top of the list (say 1-5) and made about 200k. I moved to a city still on that list (towards the bottom 1/3) and instantly made over 600k the next year. Some of that might be accounted for with career progression but the kicker is that cost of living is definitely AT LEAST 3x cheaper despite still being in a "top 20" city. I know this because we were looking for houses prior to moving in comparable suburbs close to the city and city A was like 2 million plus for anything decent and city B was like 600k. That means relatively, if you account for buying power I make NINE times more. Anecdotal, I know, but have plenty of friends who have moved and said similar.

What you said is true though- there are great jobs in the top 5 city but they are very scarce and really mostly for older/entrenched doctors or a few famous doctors that cater to the ultra-rich. There are definitely a few raking in many millions a year, but if you are a newbie doc in one of those cities just be realistic about the actual magnitude of the paycut you are taking to be near family, or ocean or "culture" or whatever.


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Both my older sisters (ages 49 and 50) in DC area. Both their homes 1.75 million and 1 million all paid off. both anesthesia.

No debt. Not earning anywhere close to 500k. More like 250k-275k these days and cutting back hours. They didn't make the big bucks either. 400-500k for a few years and starting cutting back. And they were making 120-200k for a few years in late 90s and early 2000s

Things will be a ok if u play ur cards right.

There are reasons people live in high cost areas.
Jobs
Good public Schools
Family
 
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