Why I will not be going into FM/Gen Peds/Gen IM

[SouthernSurgeon]

Getting back to the OPs posts...

Your definition of "take home pay" is very different from mine. First you've subtracted out the very expensive (and unusual) loan repayment, then you've subtracted out a large retirement savings which while admirable is certainly not common.

However your larger point stands that as student debt continues to creep upwards ( I believe now >25 % of students graduate with over 250k, and we are approaching 50% graduating with over 200k), these fields will struggle more and more to attract talented applicants.

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[Winged Scapula]

I think you just paraphrased/elaborated on what I said >.< 😛

I'm sneaky like that.

We primary differ in that 'so there's no need to educate women' isn't the next logical step in my mind.

That's us women for ya; always jumping to conclusions.

 

[Arkangeloid]

Let me disabuse you of this notion.

I'm not sure what you mean...

 

[274631]

.

 

[Brain Bucket]

I'm not sure what you mean...

That view of physicians existed over 50 years ago. How the masses now view physicians has changed drastically over the past 20 years and much of that change has occurred in the past 10. I have family in the high/supreme courts who keep me updated with the steady increase in frivolous lawsuits against physicians. I have also seen a change in the way the general public behave toward my parents vs my grandparents. I have friends who are currently attending University and are actively involved in politics, and they say that the general feeling towards physicians isn't favorable.

And my parents always told me, as a woman, to make sure and educate myself so that I can provide for myself and any children I decide to have without having to depend on a man. You may want to reconsider what your parents have told you. Most women are not waiting around to find a man to support them.

Enough is enough. Stop taking a dump on him. I recommend you improve your comprehension skills before you take the MCAT premed.

 

[274631]

.

 

[Arkangeloid]

That view of physicians existed over 50 years ago. How the masses now view physicians has changed drastically over the past 20 years and much of that change has occurred in the past 10. I have family in the high/supreme courts who keep me updated with the steady increase in frivolous lawsuits against physicians. I have also seen a change in the way the general public behave toward my parents vs my grandparents. I have friends who are currently attending University and are actively involved in politics, and they say that the general feeling towards physicians isn't favorable.

I should probably amend my statement to "the Indian emigrant community I grew up in." Which I guess is a bit of a bubble.

I guess nothing looks good for physicians wherever you go. 🙁

 

[Brain Bucket]

I should probably amend my statement to "the Indian emigrant community I grew up in." Which I guess is a bit of a bubble.

I guess nothing looks good for physicians wherever you go. 🙁

Which is why you shouldn't pursue this field unless it's what you want for yourself.

 

[Bacchus]

With the income-based repayment plan PAYE you would contribute around $10K per year towards you loans, not $35K.

Very few doctors in any specialty pay 23% of their income towards student loans. Very few doctors in any specialty stay on the 10 year standard repayment plan.

Don't get me wrong, things would be a little tight as a primary care provider if you have big dreams for a big family in an expensive state. But your argument loses credibility when you paint this worst-possible debt repayment scenario that few people follow.

So you're saying I don't have to treat chronic conditions in a metropolis like NYC? I can actually do what I want, in a small city, in an area with a decent COL, where I'll still be able to pay my loans as a PCP?

Thanks for validating my life 😛.

 

[Bacchus]

It's worth noting that most pediatricians are women, who don't need to worry about money because they can just marry a wealthy man. Us men don't have that option.

I don't know about you, but I still plan on having @Winged Scapula fund my mid-40s onward and retirement...😉

 

[Bacchus]

DING! DING! DING! We have a winner.

The competitive ones, however, can also be competitive due to lifestyle, not just gross pay. PM&R for example, which med students have now caught on.

There were a disproportionate amount of people in my class from last year that tried to get into it.

 

[Elisabeth Kate]

It's worth noting that most pediatricians are women, who don't need to worry about money because they can just marry a wealthy man. Us men don't have that option.

Every time I think your posts couldn't possibly surprise me more, you...surprise me.

 

[Elisabeth Kate]

That SPI thread is making a lot more sense now.

As is the hymen thread.

 

[Elisabeth Kate]

Holy... you must've had some experiences, Dr. Cox... I've never seen you this agitated.

With good reason. She is 100% correct.

 

[Arkangeloid]

Every time I think your posts couldn't possibly surprise me more, you...surprise me.

Y'all keep sippin dat Haterade. 🙁

Look, the point's been discussed, can we let it rest?

 

[SouthernSurgeon]

Y'all can sip dat Haterade, but I'll be sippin dat sizz, namsayin?

You should really not talk like that ever. You've indicated before that you say stuff like this IRL which is why I point it out.

 

[Arkangeloid]

You should really not talk like that ever. You've indicated before that you say stuff like this IRL which is why I point it out.

Well, yes on the "Haterade" part. As for the "sizz," the only time I use promethazine is for medicinal purposes. But if it matters that much for professional reasons, I won't talk like that IRL anymore.

 

[SouthernSurgeon]

Well, yes on the "Haterade" part. As for the "sizz," the only time I use promethazine is for medicinal purposes. But if it matters that much for professional reasons, I won't talk like that IRL anymore.

It's less a professionalism issue than it is a sounding like a giant tool issue

 

[Elisabeth Kate]

Y'all keep sippin dat Haterade. 🙁

Look, a woman has an easier time finding a sugar daddy than a man does of finding a female equivalent. That's not really debatable.

That doesn't mean that women shouldn't be educated, or that I won't educate my daughters as fully as possible.

Women who go to med school usually aren't looking for a "sugar daddy." That's not debatable either.

 

[Anastomoses]

...before I've even rotated in them:

Full time jobs in gen peds earns ~150,000. A little more in fam med and General IM.

Enter that amount into paycheckcity.com, select your state as, oh say, California.

Take home pay is $92,744 after taxes. I'll be graduating residency with around $250,000 in loans. According to the loan repayment calculator at finaid.org, a 10-year repayment plan will allow $95,240.90 of interest to be added to the principle balance. In the end, I'll have paid $345,240.90 to Uncle Sam. Divide that number out by 10 yrs, and I'll be paying ~$34,524/yr in loans.

Therefore, my take home pay of $92,744 has decreased to ~$58,220. Someone without this kind of loan burden can take this amount home with a gross salary of just ~90,000. And also, I would be 32, so I HAVE to start saving for retirement, since I will be a latecomer to the game with an opportunity cost of 10 years of time in terms of compound interest. Conventional wisdom says I should save ~20% of my gross salary JUST FOR RETIREMENT. This takes another $30,000 out of my take home pay.

Now we're down to ~$28,220.

That's what I have to work with to pay:

Rent/mortgage
Utilities
Car
Food
Insurance
Educational costs for the kids
Etc.
Etc.

A mother-effing waiter can take home as much as that. I hate to say it, but I just can't stomach that.

Weren't you premed just like 6 months ago?

 

[Arkangeloid]

Women who go to med school usually aren't looking for a "sugar daddy." That's not debatable either.

Agreed completely. But a part-time pediatrician job can't really support a family, especially not when dealing with a gigantic loan burden. And yet, pediatrics is mostly composed of women, many of whom seek or are interested in part-time positions. The women who want to work part-time can't do that without financial support coming from somewhere.

 

[Anastomoses]

As @Brain Bucket noted, you don't have to experience this personally to be affected by the disparity in which women are treated. I see it everyday in my office; women in bad relationships, teenagers coming in with babies and I just can't help but wonder if someone had taught them that the key to happiness is independence, the ability to CHOOSE for themselves what and where they wish their life to head, would things have been different for them? I probably get on my soapbox when I have teenage girls in the office but I ask all of them about their goals and aspirations and I've had at least 1 parent tell me their daughter was thinking of going to medical or vet school because of the conversation she had with me. I don't necessarily encourage them to go to medical school (and as a matter of fact, I tell them, "don't use me as a role model"), but rather just try and impart the idea that education will give them power and freedom for life. Teenagers really like that idea.

There certainly was sexism in surgical training but I felt it better to focus on the job at hand and change people's attitudes about women in surgery than make a big deal about it. Our department chair was adamant about bringing about change and more women in the residency. The female attendings were not role models for me in terms of behavior but they had certainly succeeded at a time when it was more difficult than what I was facing. My "brothers" in residency were the keys to my success and continue to be some of my best friends to this day because of their support.

Yes yes yes.

 

[mulberry]

It's less a professionalism issue than it is a sounding like a giant tool issue

I think he believes its cool to talk like that amongst his fellow LoLers (online gaming friends).

Word of advice Ark, forum/online talk is meant for just that. Remember the advice I gave you about women? Please don't ever try to make a girl laugh by using internet slang.

 

[Anastomoses]

I don't know about you, but I still plan on having @Winged Scapula fund my mid-40s onward and retirement...😉

Sugar babies are under 40. If the guy is over 40...that sorta misses the spot.

 

[punkedoutriffs]

Weren't you premed just like 6 months ago?

Started M-1 last August, so about 7-8. Yes, I was premed. Generally, you have to be a premed before you become a med student. I'm sure there are exceptions, though.

 

[Elisabeth Kate]

Agreed completely. But a part-time pediatrician job can't really support a family, especially not when dealing with a gigantic loan burden. And yet, pediatrics is mostly composed of women, many of whom seek or are interested in part-time positions. The women who want to work part-time can't do that without financial support coming from somewhere.

Working part-time doesn't mean they have a "sugar daddy." Believe it or not, many families survive just fine on a two-person income of less than $50,000 each.

 

[sinombre]

Weren't you premed just like 6 months ago?

...not sure why you think that has any relevance.

 

[notbobtrustme]

the **** is going on in this thread

 

[Frazier]

Go into whatever field that satisfies what you like most. If you cherish time off/family time most in life, find a specialty that is likely to accommodate (hint: you prob shouldn't be a neurosurgeon). If you cherish cutting people, being the leader of the ship, and having a quick definitive treatment, specialize accordingly (hint: surgery). If you love money most of all things on earth, choose a specialty most likely to provide you with copious amounts (hint: procedure focused fields).

That said, as you add more and more filters...that is when you start to get disappointed with prospects. For example, "I love my family so much, I only want to work 40 hours per week, minimal call. But, I also want to stay in California and be able to swim in my money like Scrooge McDuck...so I need a fat paycheck!"

There is certainly NOTHING wrong with any of those aspirations. All I'm saying is what you already know: it gets harder to check off all the boxes as you add more boxes to the list.

Obviously everyone is going to want a bit of the various filters...I'm saying that priorities should be made as to a definitive TOP filter.

In regards to money, a lot of it depends on the employment model.

If you are in a locked in salary FM hospital gig...there won't be much you can do about that paycheck.

If you are in a different employment model... productivity-based... PP... etc, there there is more behind the income than just a number.

Truth is that reimbursements change essentially every year. With the recent public "outing" of certain specialties as mega-earners [read: medicare release], who knows that uncle sam has up his sleeve when we turn the next corner.

If you are business savvy, hustle, and have a bit of luck, you will do well regardless of field. It doesn't matter if you went into medicine, business or law...you have the magic tools in your kit to make it happen.

If you aren't business savvy, network poorly, max out overhead, don't want to take initiative, and have no luck (i.e. you want to practice in LA, NYC, Boston, San Fran, etc 😉 ) .. you might not have a good time.

 

[DermViser]

You don't actually need to experience this first-hand. As a physician you'll see plenty of uneducated women make poor life choices. I can see why WS feels so strongly about this, and I completely agree with her post, especially the dire need for education of women, but it doesn't negate the horrible reality of Ark's post.

So true.

 

[Anastomoses]

Hey, bee nice to my parents. In this case, they're just teaching me what they knew from their culture (where we are much more communal in our outlook, and a woman's family and extended community protects her interests in a marriage). I guess it's not completely applicable here, where there are no such entities to protect the woman.

Why is it horrible? Am I horrible?

I think I have a right to point out that you accepting what your parents are feeding you is sad because I've grown up being fed plenty of nonsense.
1. You don't even know your own culture because if you think it's protective of women back in India, or in the Middle East or wherever third world hole that these ideas still exist, they don't protect women even a little. I've watched and seen it with my own eyes. If she's lucky to have brothers who will kick her hubby's ass if he messes with her too much, he'll behave. If she doesn't or even if she does, they'll always tell her to compromise and endure for the sake of...the family, dignity, children.
2. The communal outlook only protects women from the facade of sexual liberation we have tricked women into in the West, but robs them of the inherent choices to begin with that Western women are at least afforded.

See this mentality? We don't even have to look to Arkangeloid's parents. It's filthy right here in the country of liberty and freedom.

This just sickens me because it's evidence that some people really undervalue women and their contribution to society. Education is good for everyone. PLEASE BE A FORCE FOR CHANGE AND DO NOT ADOPT THESE SEXIST AND ANTIQUATED IDEAS THAT YOUR PARENTS ARE PROPAGATING. ASK YOURSELF IF YOU HAD A DAUGHTER WOULD YOU BE HAPPY FOR HER TO STAY IN A DANGEROUS OR EVEN JUST UNHAPPY RELATIONSHIP BECAUSE SHE FELT SHE HAD NO OTHER OPTIONS BECAUSE SHE COULD NOT PROVIDE FOR HERSELF IF SHE NEEDED TO?

http://abcnews.go.com/blogs/headlines/2011/08/jcpenneys-too-pretty-to-do-homework-shirt-pulled/

 

[sinombre]

It would have complete relevance on whether this belongs in Allo. A premed's speculations on why he wouldn't go into this or that would not belong here. Given that, I didn't bother reading why a premed won't go into FM or IM. Is that hard to understand?

More puzzling is you bothered to post about it.

Right, but he's not a premed, and his points are not ones that are really influenced by perspective/experience gained from medical school (at least the differences in perspective between a first and second year). If this were a thread about something where experience in medical school gave your opinion more weight (how to approach step 1, pros/cons of scheduling rotations a certain way, etc.) you would have a point. I'm not sure what's puzzling about that.

 

[punkedoutriffs]

Right, but he's not a premed, and his points are not ones that are really influenced by perspective/experience gained from medical school (at least the differences in perspective between a first and second year). If this were a thread about something where experience in medical school gave your opinion more weight (how to approach step 1, pros/cons of scheduling rotations a certain way, etc.) you would have a point. I'm not sure what's puzzling about that.

She was just a'scopin' fer 'dat 'dere potential ad hominem. Sneaky sneaky...

 

[Arkangeloid]

I think I have a right to point out that you accepting what your parents are feeding you is sad because I've grown up being fed plenty of nonsense.
1. You don't even know your own culture

But you do, I suppose.

I think we've gone way off topic at this point, but I'll just mention that it's entirely possible to be part of a non-WASP culture and support women's rights. You should check out this article, it says it a lot better than I can. Feel free to continue this over PM if you so desire.

Right, but he's not a premed, and his points are not ones that are really influenced by perspective/experience gained from medical school (at least the differences in perspective between a first and second year). If this were a thread about something where experience in medical school gave your opinion more weight (how to approach step 1, pros/cons of scheduling rotations a certain way, etc.) you would have a point. I'm not sure what's puzzling about that.

Agreed. OP is talking about sobering financial realities, something that a high school kid could calculate as well as an attending.

That said, as you add more and more filters...that is when you start to get disappointed with prospects. For example, "I love my family so much, I only want to work 40 hours per week, minimal call. But, I also want to stay in California and be able to swim in my money like Scrooge McDuck...so I need a fat paycheck!"

Basically just Derm fits that criteria I think.

 

[HLxDrummer]

I don't understand, did I say something wrong? My parents always told me that women could do any career they wanted, because they could rely on a man to provide for them. However, a man's choices are more limited, because he needs to provide for his family.

How can a women have any career if she is in the kitchen making me a sandwich?

 

[DermViser]

Basically just Derm fits that criteria I think.

There are other specialties that fit this criteria as well: Path, outpatient Psychiatry, PM&R, etc.

 

[Arkangeloid]

There are other specialties that fit this criteria as well: Path, outpatient Psychiatry, PM&R, etc.

Heh, Path. I actually liked Path a lot, and did well in that class. But I heard the job market for that specialty was abysmal.

 

[DermViser]

Heh, Path. I actually liked Path a lot, and did well in that class. But I heard the job market for that specialty was abysmal.

It depends on which program you match into and which fellowship you obtain. I liked Pathology a lot in med school as well.

 

[colbgw02]

I really hope everyone appreciates the true brilliance of Arkangeloid's posts. We are witnessing a genius among us.

 

[Arkangeloid]

I really hope everyone appreciates the true brilliance of Arkangeloid's posts. We are witnessing a genius among us.

Don't worry. I hope to prove you right soon enough. 🙂

 

[deleted500612]

Don't worry. I hope to prove you right soon enough. 🙂

lol, I think he means how brilliant you are at somehow convincing everyone you're not a troll despite your ludicrous commentaries.

 

[KnuxNole]

Or, you can live in a state not as crazy as CA 😛

 

[KnuxNole]

Despite all that they've done, my parents and community still play a big part in my life. One of the main reasons I went to medical school is to advance the honor of my family (medicine is considered the "god profession" in India).

Which is why I cringe HARD when I hear that ****, and they are shocked when someone like me freely says how medicine isn't anything close to god like..

 

[DermViser]

Which is why I cringe HARD when I hear that ****, and they are shocked when someone like me freely says how medicine isn't anything close to god like..

Wait till reimbursements start dropping like crazy, curious to see if they will still believe medicine is god-like.

 

[Siggy]

You don't HAVE to be physician to be actively involved in patient care.

You're right. You can be a mid-level in an ED, which equates to either being a permanent resident running an urgent care (fast track) or work in the middle of no-where.

 

[Geekchick921]

How can a women have any career if she is in the kitchen making me a sandwich?

 

[Mt Kilimanjaro]

..
Now we're down to ~$28,220.

A mother-effing waiter can take home as much as that. I hate to say it, but I just can't stomach that.

Hopefully this picture is clear...

It shows a montly 10-year repayment of $4,082 on an initial $258k loan debt. Subtracted from those net monthly salaries for Peds, FM and IM (~$9-10k/month) things start looking bleak when you add in mortgage, kids, car, food, etc. I really think you have to have very limited debt (less than 120k or so) or a high-earning spouse to consider some primary care specialties these days.

 

[Arkangeloid]

lol, I think he means how brilliant you are at somehow convincing everyone you're not a troll despite your ludicrous commentaries.

If I'm good enough to apparently con all these people (and the med school adcoms, as some people claim), then I'm more than good enough through the med school and residency training process.

 

[deleted500612]

Hopefully this picture is clear...

It shows a montly 10-year repayment of $4,082 on an initial $258k loan debt. Subtracted from those net monthly salaries for Peds, FM and IM (~$9-10k/month) things start looking bleak when you add in mortgage, kids, car, food, etc. I really think you have to have very limited debt (less than 120k or so) or a high-earning spouse to consider some primary care specialties these days.

View attachment 180243

"Based on 7% interest"

 

[BestDoctorEver]

The amount of taxes that people who make 150k+/year have to pay is INSANE! I am changing my party affiliation on Monday... You got a new member in your party my fellow republicans!

Can people in SDN stop posting these bleak pictures regarding PCP? Gosh!