Work for 30K?

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To allow for UHC, would you be a doc for 30K a year (if debt was reduced prop.)?

  • Yes, I'd be a doc for 30K

    Votes: 32 19.9%
  • No, I wouldn't be a doc for 30K

    Votes: 129 80.1%

  • Total voters
    161

dbhvt

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If it ensured universal health access to quality care, and debt burden was reduced proportionally, would you still want to be a physician if your take home was 30K a year?
 
No.

Now if we're talking doing your medical degree in undergrad, starting at 30k, and then slowly climbing the ladder to comparable salaries of MBAs with the added bonus of job security, maybe.

Dude, it's a huge time investment. 30k a year? Why not be a nurse at that rate? Or a PA?

Seriously, you're giving up your 20s for an education. It better be a worthwhile investment.
 
Maybe it was free to become a physician and 30K was (magically) enough to support more than myself in a 1bd apartment.
 
30K forever? If you up it to say 60K after so many years so I'd have enough to support my future family modestly, then count me in. 👍
 
HAHA. This thread is a joke. Start at 100k and we'll see from there. lol. :laugh:
 
after the current system of training and education (arguably the best in the world?)

no.

and since we can label the medical education as it is now as the best we can do, this is just a pointless argument. besides, anybody's who's worked a fulltime job knows how small 30K after tax, bills, responsibilities, etc. really is.

for those who say they would as a starting salary. do you know that that is not far from what 1st year residents are actually paid? how bout them apples?

whoever said they would. then go you. but Dr. Paul Farmer makes more than that.
 
Nope. It just does not make sense. Why would I go through so much for such a small payoff, how would I pay back my medical school loans? Imagine a surgeon working 100hrs/week for 50 weeks ( 2 weeks vacation). The surgeon would bring in $6.00 and hour. 😱
 
After incurring a $170,000 debt to get the MD, no one could feasibly work for 30K a year AND pay malpractice insurance. Depending on the specialty, malpractice can be upwards of $100, 000 - $200, 000 annually. It wouldn't work in the current system.
 
CTSballer11 said:
how would I pay back my medical school loans?

frostynorthwind said:
After incurring a $170,000 debt to get the MD...

Messerschmitts said:
...accumulate so much debt

exlawgrrl said:
it's hard enough to live on $30k without $200k plus in loan debt. add that debt in, and i think you'd be homeless.

Please read the poll question carefully. Assume debt reduction proportional to salary reduction. Ie, you will be able to pay off your loans.

Though I didn't say so in the original post, I'm also assuming this increases and decreases relative to cost of living, ie, if you're practicing in Seattle, you're going to make more. Essentially, the question asks: would you do it on a teachers salary?
 
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radioh3ad said:
for those who say they would as a starting salary. do you know that that is not far from what 1st year residents are actually paid? how bout them apples?


Yeah, I was going to mention that later.
 
Hell, I wouldn't be a teacher on a teacher's salary. It's rather unfortunate that you are trying to ask us if we would do one of the most well reimbursed (some say overpaid) professions for the salary of one of the most underpaid.
 
I draw the absolute line at $70,000. Any less than that and it's an insult to anyone who had to go through so much school and accumulate so much debt.
 
$125K is my minimum pay since this is about the average for any of the primary care docs I've shadowed.

Now if it was doing forensic pathology, I might consider working for less ($90-100K per year).
 
dbhvt said:
If it ensured universal health access to quality care, and debt burden was reduced proportionally, would you still want to be a physician if your take home was 30K a year?

Wow... you're talkin about being a doctor and getting paid the salary of a resident for life 😱 I don't know man... I'm leaning towards no... not to say that I want to be a doc because of the loot, but if I do 4 years of pre-med study, followed by 4 years of MD study, followed by 2-3 years of residency... and I'm making as much as a high school dropout who landed a gig at a car dealership, don't know If I'd be able to stomach that. Hell... at 30K/year I'm not sure there would be enough willing doctors to support UHC. Not much use to having free health care when there is no-one willing to provide it +pity+
 
NapeSpikes said:
30K forever? If you up it to say 60K after so many years so I'd have enough to support my future family modestly, then count me in. 👍

That is still reasonable in my opinion.
 
Universal health care (a single risk pool) would eliminate high overhead costs, egregious adminstrative inefficiencies, and actually give us more "bang for our buck." There is no way that physicians would ever have to accept salaries at 30k to ensure "universal" healthcare. We throw more money at this problem (per capita) than any other country in the world, with abysmal results.

Also, if MDs (or DOs) only made 30k annually, what the hell would residents make? 10? 5? nothing?
 
Praetorian said:
Hell, I wouldn't be a teacher on a teacher's salary.

So mean, yet so funny. :laugh:
 
dbhvt said:
If it ensured universal health access to quality care, and debt burden was reduced proportionally, would you still want to be a physician if your take home was 30K a year?

At least where I live, it would be virtually impossible to support a family (say, 2 parents and 2 kids) and own a house in a safe neighborhood and a car or two on that salary. And my current salary is much more than 30K a year (but still much less than typical physician salaries). So my answer is: no.
 
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if being a doctor only paid $30K than i would expect the same education as someone making $30K normally (communications major from a community college), so sure. But if it was the same as it is now, no way.
 
Praetorian said:
It's rather unfortunate that you are trying to ask us if we would do one of the most well reimbursed (some say overpaid) professions for the salary of one of the most underpaid.
👍 👍 Well said!
 
Anyone who says they would be a doctor for 30k a year is clueless to what being a doctor actually involves, that's all there is to it. Post this poll in the residents forum and see how many would do it for that. I will wager none.
 
interesting. so who are all the 'yes' voters?
 
Alexander Pink said:
Anyone who says they would be a doctor for 30k a year is clueless to what being a doctor actually involves, that's all there is to it.

It's interesting how people respond to this kind of thing. First it was said that noone would do it. After someone piped up to say they would do it, it was said that only an irrelevant minority would do it. Now, at the moment ~25% of 95 voters in the pre-med forum say they would do it, and the counter argument is that they are all clearly clueless and don't count.

Well, I voted yes, and thus am clearly clueless.

EDIT: after reading mhack's post, I think I should follow suit. Let me just say that I have a fair amount of knowledge of what it means to practice medicine, and I think Pink should be a little less liberal with his use of absolutes.

Alexander Pink said:
Post this poll in the residents forum and see how many would do it for that. I will wager none.

I would be curious to see. If we agree on reasonable terms, I will take that wager (a single vote in the residents forum means I win).
 
Goose-d said:
Universal health care (a single risk pool) would eliminate high overhead costs, egregious adminstrative inefficiencies, and actually give us more "bang for our buck." There is no way that physicians would ever have to accept salaries at 30k to ensure "universal" healthcare. We throw more money at this problem (per capita) than any other country in the world, with abysmal results.

Also, if MDs (or DOs) only made 30k annually, what the hell would residents make? 10? 5? nothing?

This is what I"ve been trying to say all along. The best indications are that if we followed a national single-payer health plan, the average physician salary wouldn't really change, but the disparity between specialities would probably narrow.
 
Alexander Pink said:
Anyone who says they would be a doctor for 30k a year is clueless to what being a doctor actually involves, that's all there is to it. Post this poll in the residents forum and see how many would do it for that. I will wager none.

Alex

I am not clueless, I will not go into my medical experience lest I sound like I am boasting - I will just say that my closest shadowing came from home because one of my 'rents is a doc.

Nonetheless, you fo'get that half of the world has physicians who earn a fraction of 30K a year and went through almost, if not more, sacrifice than we do in the U.S. and if you say, well they make less money but their expenses are lower, the argument does not hold nonetheless, they make less and spend less but in comparison, their "absolute" standard value salary is lower than any doc in the U.S.

maybe the U.S. gov. should open up a special visa for any FMG who would be willing to work here for 30K, see what happens to the physician supply and demand market :laugh:


hey let's put the poll in the FMG forum!

:laugh:
 
Goose-d said:
There is no way that physicians would ever have to accept salaries at 30k to ensure "universal" healthcare.

tigress said:
This is what I"ve been trying to say all along. The best indications are that if we followed a national single-payer health plan, the average physician salary wouldn't really change, but the disparity between specialities would probably narrow.


Honestly, I agree with you two. I don't think an %80 reduction in physician salary is necessary to ensure UHC, I just hate to see people use physician greediness as a reason to dismiss it out of hand.

Someone says, "doc's would have to work for peanuts, and they would never agree to do that."

Tigress says, "they wouldn't have to work for peanuts."

I say, "And even if docs did have to work for peanuts, who are you to say they wouldn't do it."
 
dbhvt said:
I would be curious to see. If we agree on reasonable terms, I will take that wager (a single vote in the residents forum means I win).

I think you should give it a try. While I'm sure at least one person will vote for it, I suspect it will skew quite differently from the premed forum.
 
medhacker said:
Alex

Nonetheless, you fo'get that half of the world has physicians who earn a fraction of 30K a year and went through almost, if not more, sacrifice than we do in the U.S. and if you say, well they make less money but their expenses are lower, the argument does not hold nonetheless, they make less and spend less but in comparison, their "absolute" standard value salary is lower than any doc in the U.S.
:laugh:

did they pay our medical tuition? our loans? did they have the same amount of schooling? where are your sources? i just wanna see the answers in verifiable form.

you cannot judge this question, aimed at american pre-meds, with what happens outside the U.S. realm of medicine. that is just bad reasoning.
 
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I think you'd have to throw in some more details here.

I might consider working as a doc for 30K a year IF (pardon the run on sentence) the state/federal government/private org or whatever paid all of my medical school tuition and living expenses while I was in medical school and residency AND I was able to work in the specialty I chose AND I was able to work a comfortable 35-40 hour a week schedule with adequate vacation, sick and personal time AND I was offered free health care coverage AND malpractice insurance AND doctors were still respected as professionals. 😀

Give me an office with a sofa and a fireplace too and I'd do it for 28K. 😀
 
radioh3ad said:
did they pay our medical tuition? our loans? did they have the same amount of schooling? where are your sources? i just wanna see the answers in verifiable form.

I don't think anyone in the world has compiled Doctor vs. Life expenses data abroad. I lived for several years overseas doing a medical mission in various third world countries (4) and what I claim I saw with my own eyes. Ask in the FMG forum...

you cannot judge this question, aimed at american pre-meds, with what happens outside the U.S. realm of medicine. that is just bad reasoning.

It would only be bad reasoning if the OP had not made provision for debt reduction and the other good issues you pointed at - if you go back and read it you will see he did. Therefore, the argument is not all incongruent. Thus, that is bad reading or reading too fast.
 
MB in SD said:
Maybe it was free to become a physician and 30K was (magically) enough to support more than myself in a 1bd apartment.

my thoughts exactly. it's hard enough to live on $30k without $200k plus in loan debt. add that debt in, and i think you'd be homeless. personally, i'm not looking to be wealthy, and i don't need to make six figures to be happy. but you can't even buy a house or raise a family on $30k. even if there's no debt, it's still not feasible.
 
I really doubt that anyone here who supports a family would be willing to work for 30K. It may seem like a lot when you're a single college kid living on ramen noodles, but just wait until you try to buy a house, furnish and repair a house, have a kid or two, save for retirement, etc. At least where I live, 30K just doesn't cut it. You wouldn't even be in the middle class -- you'd be one of the working poor.
 
humuhumu said:
I really doubt that anyone here who supports a family would be willing to work for 30K. It may seem like a lot when you're a single college kid living on ramen noodles, but just wait until you try to buy a house, furnish and repair a house, have a kid or two, save for retirement, etc. At least where I live, 30K just doesn't cut it. You wouldn't even be in the middle class -- you'd be one of the working poor.

True. It would be hard if you were trying to raise a family. However, as a single person, I did not find it to be too bad. Working as a receptionist I earned about 30K and was still able to afford a nice apartment, clothes, dining out and what not, but no loan debt at all and no expenses other than my own.
 
I also don't care too much about buying a house. I think the owning your own home thing is highly over-rated.
 
medhacker said:
I don't think anyone in the world has compiled Doctor vs. Life expenses data abroad. I lived for several years overseas doing a medical mission in various third world countries (4) and what I claim I saw with my own eyes. Ask in the FMG forum...



It would only be bad reasoning if the OP had not made provision for debt reduction and the other good issues you pointed at - if you go back and read it you will see he did. Therefore, the argument is not all incongruent. Thus, that is bad reading or reading too fast.

you also forget living cost. if you've worked for a living, you know 30K a year is not much at all. to provide for this country's medical needs, doctors are already overworked. so there's no point in bringing up the 40hr wk schedule.

this question was not reasoned well. quite misleading for those who don't think comprehensively. perfect for idealistic hippies.
 
The problem with the premise is that 30K is simply not enough to live in many parts of the country. If you made the salary a reasonable salary (eg 80K with no loans) I think many would say they would go through the process of becoming a physician still.

If, however, you are looking at reducing the salary of physicians as a means of funding UHC, you are grossly misinformed. The expenses that should be reduced to fund UHC are not salaries of physicians, but expenses related to administration, litigation, and profit of private health care insurance companies.
 
radioh3ad said:
you also forget living cost. if you've worked for a living, you know 30K a year is not much at all.

If you read my other replies where I stated (under affidavit if necessary), that I worked and lived for less than 30K with a family, managed to purchase a 3 bdr home!. Now, I did not have to make car payments, my vehicle was not the newest - which I did not mind nor mind now, I did not have the best medical insurance, I did not buy new clothes as frequent as the average american. We did not frequent movie theaters (who would with little children), not too many restaurants etc etc. all of this I did not mind. But yet, managed to live, purchase a new home, and overall enjoy my life, all in all under 30K.

To reply to your message, 30K is not much, but I have managed to live with that much before and if that is all I got to be a physician I would do it (and no I am not trying to depict myself as mother theresa, there play the violin for this guy... +pity+ ) I am really trying to make a point.
 
Flopotomist said:
The problem with the premise is that 30K is simply not enough to live in many parts of the country. If you made the salary a reasonable salary (eg 80K with no loans) I think many would say they would go through the process of becoming a physician still.

If, however, you are looking at reducing the salary of physicians as a means of funding UHC, you are grossly misinformed. The expenses that should be reduced to fund UHC are not salaries of physicians, but expenses related to administration, litigation, and profit of private health care insurance companies.


yeah, the loan part is a real bummer, nonetheless, the op made provision in his question with regard to debt reduction.
 
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medhacker said:
If you read my other replies where I stated (under affidavit if necessary), that I worked and lived for less than 30K with a family, managed to purchase a 3 bdr home!. Now, I did not have to make car payments, my vehicle was not the newest - which I did not mind nor mind now, I did not have the best medical insurance, I did not buy new clothes as frequent as the average american. We did not frequent movie theaters (who would with little children), not too many restaurants etc etc. all of this I did not mind. But yet, managed to live, purchase a new home, and overall enjoy my life, all in all under 30K.

To reply to your message, 30K is not much, but I have managed to live with that much before and if that is all I got to be a physician I would do it (and no I am not trying to depict myself as mother theresa, there play the violin for this guy... +pity+ ) I am really trying to make a point.

Really? This is amazing to me. I'd love some tips. I make over $30k but less than $40k right now, and there's no way I could buy a house. We're even going to have trouble paying for kids at this rate. We do save some every month, but we never go out anywhere, borrow movies from the library, etc, and our parents are helping with cell phone bills and other support here and there. We don't mind that at all (actually we're not the going out type anyway, nor do I care much about fashion or new clothes).

(I'm not trying to be a part of this argument at all right now. I'm really truly curious about how you managed to do what you're saying. I'm sure location matters a lot, of course.)
 
medhacker said:
If you read my other replies where I stated (under affidavit if necessary), that I worked and lived for less than 30K with a family, managed to purchase a 3 bdr home!. Now, I did not have to make car payments, my vehicle was not the newest - which I did not mind nor mind now, I did not have the best medical insurance, I did not buy new clothes as frequent as the average american. We did not frequent movie theaters (who would with little children), not too many restaurants etc etc. all of this I did not mind. But yet, managed to live, purchase a new home, and overall enjoy my life, all in all under 30K.

To reply to your message, 30K is not much, but I have managed to live with that much before and if that is all I got to be a physician I would do it (and no I am not trying to depict myself as mother theresa, there play the violin for this guy... +pity+ ) I am really trying to make a point.
👍 👍 for medhacker

My parents did that with three kids and 35K, and now they have a 3BR house as well. How, you say? Little luxuries were given up. I never saw a movie in the theaters when I was growing up, we saw doctors only when we had to, our family car was old and ugly, waited for clearance sales to buy tennis shoes, etc. Oh, and this was all in Southern California.

And all in all, I think I turned out okay. So yes, given the stipulations presented by the OP, and my own caveat of being able to work my way up to a higher income over the years, maybe maxing at 60K (what do teachers max out at?), I'd still want to be a physician.
 
tigress said:
Really? This is amazing to me. I'd love some tips. I make over $30k but less than $40k right now, and there's no way I could buy a house. We're even going to have trouble paying for kids at this rate. We do save some every month, but we never go out anywhere, borrow movies from the library, etc, and our parents are helping with cell phone bills and other support here and there. We don't mind that at all (actually we're not the going out type anyway, nor do I care much about fashion or new clothes).

(I'm not trying to be a part of this argument at all right now. I'm really truly curious about how you managed to do what you're saying. I'm sure location matters a lot, of course.)

It is probably location, I did this in south Florida. Now that I have lived up north I can confirm some things were lower priced downthere. My house (brand new BTW) was built in the suburbs, bought it at about 87K monthly payments including P & I were about $850 (yard and porch). My 'rents helped from time to time with clothes for the kids and toys at times. But basically it was just due to our consistent thrifty attitude. Spend wisely on food and clothes, forget about brand names, those will drain your wallet. Eat grains, vegetables and meats you can cook at home, as opposed to buying tv dinners and frozen foods, you will be surprised how anti-economical those can be.

So it's little things like that, you are not doing too bad, you said you are saving some every month. I could not save any at all every month. We still managed to visit Mickey mouse and terminator with the kids from time to time though.
 
medhacker said:
It is probably location, I did this in south Florida. Now that I have lived up north I can confirm some things were lower priced downthere. My house (brand new BTW) was built in the suburbs, bought it at about 87K monthly payments including P & I were about $850 (yard and porch). My 'rents helped from time to time with clothes for the kids and toys at times. But basically it was just due to our consistent thrifty attitude. Spend wisely on food and clothes, forget about brand names, those will drain your wallet. Eat grains, vegetables and meats you can cook at home, as opposed to buying tv dinners and frozen foods, you will be surprised how anti-economical those can be.

So it's little things like that, you are not doing too bad, you said you are saving some every month. I could not save any at all every month. We still managed to visit Mickey mouse and terminator with the kids from time to time though.

but to live that lifestyle? with doctor's hours? you won't be with the kids much at all. you will have to find a housewife or a nanny. you are making a point i see but i doubt if it came down to it, that anyone would stay in a doctor's profession for 30K. you don't even know what the life is like. shadowing or not.

cheers to you for doing this in south florida. try doing it in NYC. 30K will not allow you to live with a family anywhere near manhattan without taking out loans or TRULY sacrificing everything but the bare necessities.... or relying on illegal measures.
 
medhacker said:
It is probably location, I did this in south Florida. Now that I have lived up north I can confirm some things were lower priced downthere. My house (brand new BTW) was built in the suburbs, bought it at about 87K monthly payments including P & I were about $850 (yard and porch). My 'rents helped from time to time with clothes for the kids and toys at times. But basically it was just due to our consistent thrifty attitude. Spend wisely on food and clothes, forget about brand names, those will drain your wallet. Eat grains, vegetables and meats you can cook at home, as opposed to buying tv dinners and frozen foods, you will be surprised how anti-economical those can be.

So it's little things like that, you are not doing too bad, you said you are saving some every month. I could not save any at all every month. We still managed to visit Mickey mouse and terminator with the kids from time to time though.

Yeah, I think the cost of living is just higher here. At least housing prices are way higher. But I live in a really expensive area (suburbs of Philly). We actually only shop sales at the supermarket, and buy in bulk and store things when there's a good sale. Most people are shocked at how low our grocery budget is. Oh, and we don't eat meat, so that saves a lot. We actually never buy clothes...well, like twice a year to get what we need for upcoming seasons (I hate shopping). I'm a real tightwad when it comes to clothes, or most other things for that matter. The one thing we don't skimp on is books for my husband's med school, or equipment (he just had to get his ophthalmoscope and otoscope). Actually that's probably the one luxury we allow ourselves: we sometimes do buy books. Mostly I go to the library. We haven't even turned on the air conditioner through 2 summers living in this apartment in order to save money on electricity (and because we're masochists and like the idea of living without a/c 😛)!

So yeah, it can be done, living like this. And we don't even spend all of our time worrying about money, it's just an issue of forming good habits. We could spend more money and end up not being able to save, but saving is worth it to us. I don't know how people do it with kids, though. Just the cost of diapers, clothing, etc., is going to put us over the line. So you certainly have my respect for making it work!

edit: I forgot to mention that we're incredibly happy and satisfied with our lifestyle at this stage in our lives. That's not to say I want to spend the rest of my life like this. I'm willing to, yes, but of course I'd prefer being able to buy red peppers instead of green! :laugh: Hopefully these habits will help us when trying to pay of loans, though.
 
Yeah, it's all about adjusting to a different lifestyle when it comes to living on a budget. Just to compare two of my friends. One is the child of immigrant parents who came to the US dirt poor. Even though she now works as an IT technician and makes around 45K a year she still shops sales, buys her clothes at Walmart and other discount stores, buys her groceries in bulk and eats very inexpensive meals like rice, soup and pasta. She always brings her lunch to work and never wants to order or go out for food, even for a slice of pizza, because she thinks it's a waste of money to spend $3 on a lunch. I think this lifestyle is really all she knows and she's comfortable with it. She's managed to save lots of money but I have no idea what she's going to do with it since she lives so frugally and wants for nothing. My other friend makes a bit more money working in accounting, maybe 55K. However, she's from an upper middle class family and is used to having all kinds of luxuries. While my other friend is comfortable living in a slightly sketchy part of town, this friend insists on living in a ritzy neighborhood, where she pays about 3K a month for a 3 bedroom. She's also still paying off her Land Rover, while my other friend takes the bus. She spends insane amounts of money on lingerie at La Perla and shops for high end clothes at Saks and Bloomingdales. She's on the verge of maxing out her credit cards and can barely pay her rent.
Well perhaps I am rambling...but all this to say it depends a lot on what type of lifestyle you are comfortable with and it's all about getting used to a different way of living when you're on a budget. It can be done.
 
There's another, larger issue here. Should any doctor assume the personal and professional liability and risk of practicing medicine for a reimbursement of only 30K? No. It is wrong...dangerous, even.
 
PineappleGirl said:
Yeah, it's all about adjusting to a different lifestyle when it comes to living on a budget. Just to compare two of my friends. One is the child of immigrant parents who came to the US dirt poor. Even though she now works as an IT technician and makes around 45K a year she still shops sales, buys her clothes at Walmart and other discount stores, buys her groceries in bulk and eats very inexpensive meals like rice, soup and pasta. She always brings her lunch to work and never wants to order or go out for food, even for a slice of pizza, because she thinks it's a waste of money to spend $3 on a lunch. I think this lifestyle is really all she knows and she's comfortable with it. She's managed to save lots of money but I have no idea what she's going to do with it since she lives so frugally and wants for nothing. My other friend makes a bit more money working in accounting, maybe 55K. However, she's from an upper middle class family and is used to having all kinds of luxuries. While my other friend is comfortable living in a slightly sketchy part of town, this friend insists on living in a ritzy neighborhood, where she pays about 3K a month for a 3 bedroom. She's also still paying off her Land Rover, while my other friend takes the bus. She spends insane amounts of money on lingerie at La Perla and shops for high end clothes at Saks and Bloomingdales. She's on the verge of maxing out her credit cards and can barely pay her rent.
Well perhaps I am rambling...but all this to say it depends a lot on what type of lifestyle you are comfortable with and it's all about getting used to a different way of living when you're on a budget. It can be done.

I'm sure there is a great deal of truth to this. However I grew up in an upper middle class household and I'm very comfortable living frugally on a strict budget. It might have a lot to do with individual personality on top of background. I'm sure there are plenty of people from poorer backgrounds who aren't comfortable living on a low salary, too.

Not that I disagree, really. It's probably true much of the time.
 
No, I wouldn't. I want to have several children and provide a good upbringing for them. I wouldn't spend over a decade of my years after HS just to make $30K, and I'd probably still be working long hours (50-60+ hrs/wk). I'm not looking to get rich as an MD, but I'd at least like to have a comfortable family life.
 
PineappleGirl said:
I also don't care too much about buying a house. I think the owning your own home thing is highly over-rated.
Why's that? It's a far better investment than simply spending your money on monthly rent for the rest of your life. The tax write-offs from the mortgage interest, the collateral you accumulate, etc., are huge benefits.
 
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