Are there less competitive ROAD-lifestyle specialties for the average student?

[postbacpremed87]

Psy is actually pretty diverse. It really depends on what area you end up in. Can be around 200K as your primary job and then another 50K with your secondary job. I have would assume around 250K if you work around 50hrs.

If you can establish a cash private practice then you can clear 300K +.

Hard to do but I have met 3 that have. They love life...haha.

If you are willing to work some places and a little harder you can get closer to the 250K range with still a good lifestyle.

Don't advertise this too much, haha.

---

Members don't see this ad.

 

[J ROD]

250k with a 50 hr work week is still a fantastic lifestyle.

Like I said, it is possible. But, might not be the best, easiest job.

 

[touchpause13]

Here's what I've kinda wondered. Would it be legal to moonlight in a private practice, cash only situation as a resident?

 

[GUH]

Here's what I've kinda wondered. Would it be legal to moonlight in a private practice, cash only situation as a resident?

A medical license is a medical license.

 

[touchpause13]

A medical license is a medical license.

Huh.
Wow. I could make like so much extra money.

 

[postbacpremed87]

Huh.
Wow. I could make like so much extra money.

It's not unheard of to make over 100k as a psych resident (including moonlighting obviously). Imagine the loan payoffs

 

[touchpause13]

It's not unheard of to make over 100k as a psych resident (including moonlighting obviously). Imagine the loan payoffs

 

[postbacpremed87]

View attachment 180877

200k-250k for psych is a good deal if the field is for you. It is arguably one of the best lifestyle specialties. If people get over their desire for a BMW 5 series every 3 years and a 800k home, then 200k-250k is mighty fine.

That's a nice Acura, 500k house paid off rapidly, and many trips to Europe....or whatever you want.

 

[touchpause13]

200k-250k for psych is a good deal if the field is for you. It is arguably one of the best lifestyle specialties. If people get over their desire for a BMW 5 series every 3 years and a 800k home, then 200k-250k is mighty fine.

That's a nice Acura, 500k house paid off rapidly, and many trips to Europe....or whatever you want.

I would be very happy with that kinda money. Especially since I wouldn't be the only one bringing home bacon

 

[postbacpremed87]

I would be very happy with that kinda money. Especially since I wouldn't be the only one bringing home bacon

Me too. My wife loves her job and will continue working. It enables me to not feel so much pressure and I can choose a field I truly like. Not reaching for glory (read material possessions) really takes the pressure off and makes you realize how far 200-250k can go. It's even better if your spouse supplements it.

 

[postbacpremed87]

I would be very happy with that kinda money. Especially since I wouldn't be the only one bringing home bacon

I know you are going to work hard touchpause, but isn't it nice that you like a field that most people overlook? You aren't gunning for ortho, plastics, or derm. If you keep your head down, enjoy med school, learn a lot, then you will get into a good residency program and be a psych. It will be hard, but there's less weight on your shoulders.

 

[J ROD]

I was living high off the hog with 125K as a pharmacist.

 

[Silent Cool]

I'm in the middle of my second year now, and I'm not sure exactly what field of medicine I want to pursue. I know it's still kind of early, but I would like to have some idea of what I want to do one day. The only thing that I know for sure is that I want to have a structured lifestyle, not work 80 hour weeks the rest of my life, and have solid pay. (I know - we all want this...).

I also know the best lifestyle/pay fields at the moment are the ROAD specialties. We know they are some of the most difficult to match into though and you have to be at/close to the top in your class. .

Personally, I'm just average in my class. Since chances for the ROADs will be realistically hard for me to match into, I was wondering if there are any other fields out there that can still offer a desirable lifestyle/pay yet be more realistic for the average medical student..

Are there any that offer a good lifestyle/pay for less competitive students? If so, which ones?.

Dentistry

 

[bionerd89]

200k-250k for psych is a good deal if the field is for you. It is arguably one of the best lifestyle specialties. If people get over their desire for a BMW 5 series every 3 years and a 800k home, then 200k-250k is mighty fine.

That's a nice Acura, 500k house paid off rapidly, and many trips to Europe....or whatever you want.

Where I'm from, 800K would barely get you a home.

 

[postbacpremed87]

Where I'm from, 800K would barely get you a home.

Eh...I am in a low cost of living state.

 

[touchpause13]

Where I'm from, 800K would barely get you a home.

Haha that sucks

 

[GUH]

Where I'm from, 800K would barely get you a home.

Perhaps, but then again most people do not expect to pay off their homes in just a few years.

 

[DocEspana]

all this focus on money. Focus on happiness. what do you enjoy doing?

I personally enjoy giving patients high on PCP nimbex until they stop moving (because ive deadened their nerve endings).

 

[Postictal Raiden]

all this focus on money. Focus on happiness. what do you enjoy doing?

I personally enjoy giving patients high on PCP nimbex until they stop moving (because ive deadened their nerve endings).

I enjoy making money..............................................................and of course, helping patients!

just kidding...

 

[touchpause13]

all this focus on money. Focus on happiness. what do you enjoy doing?

I personally enjoy giving patients high on PCP nimbex until they stop moving (because ive deadened their nerve endings).

I love you.

For real I think psych will make me happy. And not just because of money.

 

[bionerd89]

all this focus on money. Focus on happiness. what do you enjoy doing?

I personally enjoy giving patients high on PCP nimbex until they stop moving (because ive deadened their nerve endings).

Before applying to med school I was only interested in primary care, specifically family medicine. However, after seeing the tuition and realizing how much debt I'll be in I realized family medicine might not be very practical. I'm hoping to eventually to return to my home state which has one of the highest cost of living so money is definitely something I have to consider.

 

[vanfanal]

Same as what touchpause said. Although it's always reassuring to know that all the hard work has its financial pay offs. I guess the disparity between specialties still irks people (and me), but that's where lifestyle considerations come in, something I admittedly cannot fully appreciate at this stage.

 

[DocEspana]

Before applying to med school I was only interested in primary care, specifically family medicine. However, after seeing the tuition and realizing how much debt I'll be in I realized family medicine might not be very practical. I'm hoping to eventually to return to my home state which has one of the highest cost of living so money is definitely something I have to consider.

Let me rephrase it.

With only a few jobs with legitimately "low by doctor standards" income potentials, why are we making money the center point of discussions of the remaining 80% of the fields that makes more than sufficient money. Having more money is spectacular, but once you hit a certain threshold you're making more than enough where it becomes "do you wanna be well off, wealthy, or grossly wealthy?"

when discussing fields that'll make enough money, I just feel like the actual income should be second or third most important. Still a very serious element, but at this point something you may truly enjoy is making a not overly significant amount less than something you might not enjoy.

 

[wjs010]

i just HOPE that I really really find what I THINK I will love doing by 3rd or 4th year...I know my initial interests, so I'm very excited to see if these superficial interests match up to watch residency I end up in . I am also one of those people who almost went to PT school and found out later about PMR. PMR sounds awesome, but I don't know anything yet. lol

 

[hallowmann]

i just HOPE that I really really find what I THINK I will love doing by 3rd or 4th year...

I know right, I really hope that too. For now, I guess I should just prep myself for the most competitive field on my shockingly long potentials list.

I love you.

For real I think psych will make me happy. And not just because of money.

Because of the hours too, right??

 

[touchpause13]

Because of the hours too, right??

I think psych is just interesting as hell. I've been around the patients before and loved it. I like the type of relationships formed, and I think I'd be good at it.

The ability to still spend time with family is obviously a plus and being ablen to pay off my loans at a reasonable pace doesn't hurt either.

 

[DocEspana]

Mind the phrasing here, but all you psych fans are nuts.

 

[touchpause13]

Mind the phrasing here, but all you psych fans are nuts.

What did the psychiatrist say to the naked guy?

I can see your nuts!

 

[Dharma]

Easy to focus on money or how awesome a field is before you actually taste what the-real is all about.

 

[worfndata]

You can LOVE something when its in moderation but HATE it in excess. So say you love Surgery but hate long hours, you will end up hating surgery. So in my mind considering things like hours/days worked is a perfectly rational basis for choosing a specialty.

 

[IslandStyle808]

Where I'm from, 800K would barely get you a home.

I know your pain.

 

[Haxx]

I know your pain.

Just to rub it in: 800k where I'm from = 4-6 BR, 3-4k sq ft, with your most desireable location.

i.e.
http://www.realtor.com/realestatean...Blvd_Minneapolis_MN_55410_M85490-47652?row=21

or

http://www.realtor.com/realestatean...ve-S_Minneapolis_MN_55408_M84306-49901?row=31

 

[DermViser]

Let me rephrase it.

With only a few jobs with legitimately "low by doctor standards" income potentials, why are we making money the center point of discussions of the remaining 80% of the fields that makes more than sufficient money. Having more money is spectacular, but once you hit a certain threshold you're making more than enough where it becomes "do you wanna be well off, wealthy, or grossly wealthy?"

when discussing fields that'll make enough money, I just feel like the actual income should be second or third most important. Still a very serious element, but at this point something you may truly enjoy is making a not overly significant amount less than something you might not enjoy.

Bc there is this thing called income tax, loan repayments, malpractice etc. and many other expenses that comes into play esp. if you want to get on with your life.

 

[IslandStyle808]

Just to rub it in: 800k where I'm from = 4-6 BR, 3-4k sq ft, with your most desireable location.

i.e.
http://www.realtor.com/realestatean...Blvd_Minneapolis_MN_55410_M85490-47652?row=21

or

http://www.realtor.com/realestatean...ve-S_Minneapolis_MN_55408_M84306-49901?row=31

Thank you for rubbing salt in the wound (I kid). Here is a comparable house to your first link for the same price.

http://www.realtor.com/realestatean...Makena-St_Kaneohe_HI_96744_M72077-31497?row=4

Notice the sq. ft. on this sucker, it is like 1/2 the size of the house you had on your first link! That house on your first link even has two stories! This is unfair!

 

[DocEspana]

Bc there is this thing called income tax, loan repayments, malpractice etc. and many other expenses that comes into play esp. if you want to get on with your life.

Doesn't income tax apply to every job in existence? (It does)

Doesn't income tax impact high earners proportionally less than low earners, making doctors pay a lower % of their income than other fields? (it does, your rate of taxation drops above a certain income)

Doesn't loan repayment apply to pretty much any master/professional level degree (it does), which makes medicine the most lucrative of the high loan fields? (Unless your loan is from an *elite* business school and you become a chief officer at an usually lucrative business, physician will be by far the most lucrative)

Isn't it generally agreed that no other field with large loans can 'take advantage' of the PSLF to eliminate loans very prematurely to the level physician can? (It's such an agreed upon thing that the Fed uses doctors as a reason why they need to cut it back for everyone)

Aren't all of the income values you see online "post-" all of this stuff, and thus they represent the take home value* (they are*)

My point being... There are nearly no poor doctors. Just ones that get paid better than others. The conflict comes when the pediatrician feels he works harder than the ophthalmologist but gets paid 1/3 the money. Does t mean his 1/3 isn't objectively large. Only that the ophthalmologist makes silly good money for the work hours. Pay per hour and the potential for 1st percentile incomes are real factors. But I just dint think their that vital when the worst possible outcome is being in the 2nd percentile of earners in America.**

* obviously some do not include overhead and I could believe some might not include malpractice, but everything I've seen has been post tax and post benefits contribution and post malpractice. +/- personal business overhead since that does t apply to all fields or even all doctors in fields it can apply to.

** If you earn $150,000 you are in the 98th percentile of incomes in the US.

 

[DermViser]

Doesn't income tax apply to every job in existence? (It does)

Doesn't income tax impact high earners proportionally less than low earners, making doctors pay a lower % of their income than other fields? (it does, your rate of taxation drops above a certain income)

Doesn't loan repayment apply to pretty much any master/professional level degree (it does), which makes medicine the most lucrative of the high loan fields? (Unless your loan is from an *elite* business school and you become a chief officer at an usually lucrative business, physician will be by far the most lucrative)

Isn't it generally agreed that no other field with large loans can 'take advantage' of the PSLF to eliminate loans very prematurely to the level physician can? (It's such an agreed upon thing that the Fed uses doctors as a reason why they need to cut it back for everyone)

Aren't all of the income values you see online "post-" all of this stuff, and thus they represent the take home value* (they are*)

My point being... There are nearly no poor doctors. Just ones that get paid better than others. The conflict comes when the pediatrician feels he works harder than the ophthalmologist but gets paid 1/3 the money. Does t mean his 1/3 isn't objectively large. Only that the ophthalmologist makes silly good money for the work hours. Pay per hour and the potential for 1st percentile incomes are real factors. But I just dint think their that vital when the worst possible outcome is being in the 2nd percentile of earners in America.**

* obviously some do not include overhead and I could believe some might not include malpractice, but everything I've seen has been post tax and post benefits contribution and post malpractice. +/- personal business overhead since that does t apply to all fields or even all doctors in fields it can apply to.

** If you earn $150,000 you are in the 98th percentile of incomes in the US.

Doesn't income tax apply to every job in existence? (It does)
--- Yes, except being in the first and second tax bracket takes out a HUGE chunk of your salary. Remember nearly 47% of the country pays absolutely NO federal income tax whatsoever. This is before you even get to pay one dime towards your student loans.

Doesn't income tax impact high earners proportionally less than low earners, making doctors pay a lower % of their income than other fields? (it does, your rate of taxation drops above a certain income)
--- Most doctors don't have the level of deductions that those in the "elite" have nor do they make most of their money from capital gains in which it is taxed lower than actual salary income. So no, high earners aren't necessarily taxed proportionally less than low income earners. Thank you for falling for the Democratic talking points though.

Doesn't loan repayment apply to pretty much any master/professional level degree (it does), which makes medicine the most lucrative of the high loan fields? (Unless your loan is from an *elite* business school and you become a chief officer at an usually lucrative business, physician will be by far the most lucrative)
--- the BIG difference is that the level of loans is in the SIX FIGURES which is a mortgage of a house without having the actual physical house with 6-7% interest on federal loans and much higher for private loans, with a huge delay in paying it off as it's not fiscally practical to pay student loans during residency when you're living hand to mouth. Depending on the specialty, the ROI is very much different and would hardly classify as being "lucrative".

Isn't it generally agreed that no other field with large loans can 'take advantage' of the PSLF to eliminate loans very prematurely to the level physician can? (It's such an agreed upon thing that the Fed uses doctors as a reason why they need to cut it back for everyone)
--- You're assuming that PSLF is going to be there forever. PSLF is subject to the whims of Congress to either cut back on it or get rid of it altogether. There is absolutely no guarantee on anything from the govt.

Aren't all of the income values you see online "post-" all of this stuff, and thus they represent the take home value* (they are*)
--- The income values that you see posted on ads (if they even list it) is BEFORE income tax.

My point being... There are nearly no poor doctors. Just ones that get paid better than others. The conflict comes when the pediatrician feels he works harder than the ophthalmologist but gets paid 1/3 the money. Does t mean his 1/3 isn't objectively large. Only that the ophthalmologist makes silly good money for the work hours. Pay per hour and the potential for 1st percentile incomes are real factors. But I just dint think their that vital when the worst possible outcome is being in the 2nd percentile of earners in America.**

---The issue is not poor or rich. It's the ROI and opportunity cost for the amount of trouble. For primary care, the ROI is not as good as specialty medicine. For primary care, you would be better off doing NP or PA with a MUCH BETTER ROI. Something I'm sure you are well aware of being a budding urologist/emergency medicine doc (you know, before you were considering Plastics, General Surgery, or Ophthalmology)

 

[DocEspana]

--- Yes, except being in the first and second tax bracket takes out a HUGE chunk of your salary. Remember nearly 47% of the country pays absolutely NO federal income tax whatsoever. This is before you even get to pay one dime towards your student loans.

No. Thats compeltely false. First off you are isolating out the federal tax but excluding the federal PAYROLL tax (for god knows what reason, those two things are never considered together). Nearly 47% of the country OVERPAYED their federal income taxes through their bi-weekly payroll tax and thus when 'tax time' comes the government gives them back money since their income contribution outweighed their federal 'non-income' requirement. In reality, call it what it is. 47% of americans were too tax naive to realize they gave the government an interest-free loan that exceeded (often far exceeded) the amount they actually owed. 53% of us dont pay what we actually owe by tax time and have taxes due at the end of the year. And we will get to tax brackets in a second.

That 47% is further bolstered because temporary tax cuts that the 2009 Recovery Act created, including the “Making Work Pay” tax credit and an exclusion from tax of the first $2,400 in unemployment benefits, dropped millions of people into a broad category of "owing nothing". Both of these temporary tax measures have since expired, so expect that number of people who nominally are 'tax free' (term used lightly) to drop.

From Howard Gleckman himself, the author of the document that the 47% dont pay taxes comes from:

"Let me explain — repeat actually — what [the figure] means: About half of taxpayers paid no federal income tax last year. It does not mean they paid no tax at all. Eighty-three percent shelled out Social Security and Medicare payroll taxes. Nearly all owed the full amount of state taxes. [….] Some paid property taxes and, it is fair to say, just about all of them paid sales taxes of one kind or another. So to say they pay no taxes is flat wrong."

Most doctors don't have the level of deductions that those in the "elite" have nor do they make most of their money from capital gains in which it is taxed lower than actual salary income. So no, high earners aren't necessarily taxed proportionally less than low income earners. Thank you for falling for the Democratic talking points though.

Let me clarify for those who don't know. The amunt of money he is calling "elite" is $100,o00. AKA, the point at which you stop paying further payroll tax at any significant percentage. I doubt you will find an employed doctor in america who doesn't earn at least that much. But lets go a step futher.
http://www.nytimes.com/2013/11/02/business/high-earnings-low-taxes-and-never-a-bad-year.html?_r=0

According to the congressional budget office: low and moderate income people pay a much larger share of their incomes in federal payroll taxes than high-income people do: taxpayers in the bottom 20 percent of the income scale paid an average of 8.8 percent of their incomes in payroll taxes, compared to 1.6 percent of income for those in the top 1 percent of the income distribution thanks to scaling of taxes paid and a cutoff when no more significant tax is paid (not payroll is not all tax, but it is a pretty big chunk of it)

Thanks to built in rules (partially to do with capitol gains, but in no way dependent on them) the tax bracket income numbers are a joke. As you increase in salary your tax rate goes from 10 to 15 to 25 to 28 to 24.3 to 23.8. It goes another step lower but thats 1) an esoteric group of multi millionaires and 2) nowhere that an MD or DO will be. "But DocE" you say, the first page i hit on google says 33, 35 and 40%. Yes it does, inquisitive fellow, I respond. Except that is what is dictated by the IRS as the standing tax rate and doesnt take into account two other laws current on the books that give people who earn in the 33, 35 and 40% tax brackets functionally a 10-15% tax break from their IRS standing rate, AND that any amount of their income that is not true income but rather capitol gains is taxed lower and thus lowers the functional tax rate even further.

"but DocE" you mutter 'you must be using those tax exemptions I hear about to get to that number.' I shake my head sadly. "no. no im not. this is prior to any tax exemptions. This is why places like H&R block exist, because the rich really cna save billions (combined) by realizing when they are overpaying without taking advantage of a single loophole, just using what laws are in the books and would be applied by anyone who simply reads the rules as to what they owe. Forget about using ACTUAL loopholes"

and by the way, the amount needed to be at that 24% total tax where it starts turning the corner to lower taxation? $193,000. a reasonable amount for nearly all fields (though some fields will have a hard time reaching that)

the BIG difference is that the level of loans is in the SIX FIGURES which is a mortgage of a house without having the actual physical house with 6-7% interest on federal loans and much higher for private loans, with a huge delay in paying it off as it's not fiscally practical to pay student loans during residency when you're living hand to mouth. Depending on the specialty, the ROI is very much different and would hardly classify as being "lucrative".

1) How are the loans given to lawyers (Equal cost of attendance, no loans for living or eating so they need private loans too, 3 years long), PhDs (the same as physicians, but again with private loans for room/board) or MBAs (SIGNIFICANTLY higher cost of attendance, 2 years) any different? answer. They're not. Its the difference of 150K vs 200K vs 250K (phsicians being the first or middle one, not the highest one. Thats elite MBAs)

2) see the below point on PSLF

3) http://murdockconsultingmd.com/blog/view/mgma-2012-primary-care-comp-survey . In what world are those numbers not lucrative? Those are payroll reported POST DEDUCTION incomes. some are more than others. some are MUCH more than others. but very few would be not qualifiable as lucrative in an objective sense.

--- You're assuming that PSLF is going to be there forever. PSLF is subject to the whims of Congress to either cut back on it or get rid of it altogether. There is absolutely no guarantee on anything from the govt.

Education department recently reaffirmed that no matter what government does, the contracts signed once you start taking out your loans will be honored and specifically pointed out that the PSLF program with its forgiveness clause are spelled out in that contract. The fed wants to change what options are available for future lenders, they wouldnt risk breaching contract with lawyers and physicians of america.

--- The income values that you see posted on ads (if they even list it) is BEFORE income tax.

Didn't say the ads. I said the compensation reports. Which are all post-tax.

The issue is not poor or rich. It's the ROI and opportunity cost for the amount of trouble. For primary care, the ROI is not as good as specialty medicine. For primary care, you would be better off doing NP or PA with a MUCH BETTER ROI. Something I'm sure you are well aware of being a budding urologist/emergency medicine doc (you know, before you were considering Plastics, General Surgery, or Ophthalmology)

Im well aware of ROI. Except PA costs >$100,000 nowadays. And the 5-7 extra years of income get really quickly recouped when you make 2-5x the income (when comparing similar fields. A plastic surgery PA makes almost as much as a poor FP doc. But FP to FP or plastics to plastics the MD/DO vs PA divide is quite large). It will take time, but dragging ancillary providers into the ROI argument is a comical thing given that thought process is generally the land of the disillusioned older physician with no clue of the actual numbers in play, not the persn who actually looked at the numbers and made the educated decision. My partner is a PA. I know the income options for her EXCEPTIONALLY well. and the cost of geting those options is still pretty damn high. People become PAs because they truly want to treat patients and not deal with the 'physican medicolegal' bulls***, or they were unable to do what it took to be a MD/DO. They dont do it becuase its a sound investment, at least not compared to MD/DO.

Now nowhere will I disagree with you that there is a massive ROI difference between FP and ophtho. But people here are debating PM&R vs Psychiatry on the basis of money. Its absurd. and the difference between EM or Plastics is really an absurd argument too, becuase unless being 'crazy wealthy (potentially)' is an absolute desire, the income difference between the two is large but lifestyle-irrelevant. Yu can do whatever you want with either if whatever you want doesnt include owning multiple yachts.

 

[DocEspana]

I feel like I may have accidentally started a fight. I'm going to put my political hat away. Lets leave it at, I personally feel that the income differential between nearly all the fields being discussed here is not that big of a deal. Lifestyle reprocussions and 'fit' should be much more relevant as long as youre not comparing a specialty field to pediatrics or FP. And as far as I noted, no one was. Sure its a factor, but making it so prominent seemed to be really missing the forest for the singular hundred dollar-plated tree.

I look at my theoretical future income potential and salivate. but I'd do the same at $150K as $450K. I realize there is a large functional difference in what you CAN do with those two numbers, but when everyone is debating jobs in the $250-$325K range... we're splitting hairs to focus on the "better income" when lifestyle and fit is infinitely more important than the 75K swing zone they exist in. (now someone shows up and says they want to do transplant surgery, well then thats a different ballpark. but its also not "less competitive... for the avergae student")

 

[TXPMR]

Now nowhere will I disagree with you that there is a massive ROI difference between FP and ophtho. But people here are debating PM&R vs Psychiatry on the basis of money. Its absurd. and the difference between EM or Plastics is really an absurd argument too, becuase unless being 'crazy wealthy (potentially)' is an absolute desire, the income difference between the two is large but lifestyle-irrelevant. Yu can do whatever you want with either if whatever you want doesnt include owning multiple yachts.

This cannot be said loud enough.

I think the problem is that med students are used to competing all their lives and so "income potential" is the logical next step in terms of something to compete on. The problem is that the difference in income potential among physicians is largely marginal as ALL physicians have the capacity to at least be among the top income earners in the country, but pretty much no physicians have the capacity to be super duper rich. This goes without mentioning the potential opportunity costs associated with increasing marginal income (hours worked, stress on the job, etc.). Med students will see a specialty with 500k/year and get oogly eyed and poo poo on a specialty that's 200k/year...without considering desired lifestyle and what they would ACTUALLY do with the extra 300k a year. In life, there gets to a point where more money doesn't buy happiness.

People lose sight of the fact that the average American household income is in the 50ks. If you are a physician you are set for life. And if you are a physician in a two income household you are really set for life. You may not own that private jet, but if you want to be uber wealthy, don't do medicine. But then again, striking it REALLY rich is more about luck (or inheritance) than actual merit. So it remains that medicine more than ANY OTHER profession is the safest, surest way to become one of the top income earners in the country.

 

[DermViser]

If you are a physician you are set for life. And if you are a physician in a two income household you are really set for life. You may not own that private jet, but if you want to be uber wealthy, don't do medicine. But then again, striking it REALY rich is more about luck (or inheritance) than actual merit. So it remains that medicine more than ANY OTHER profession is the safest, surest way to become one of the top income earners in the country.

 

[DOcusate]

I'd like to see how some of the opinions in here change once people start having kids and need to consider things like living in a good school district, paying for college, planning for unforseen medical bills, etc.

 

[DocEspana]

Come from a family of healthcare lawyers.... Always been told the difference between the surgeon who is apparently cash strapped and the hosoitalist who vacations across the world is good investing in those first few years versus "money to burn" at syndrome.

Seems relevant here.

 

[TXPMR]

The point is not that physicians are guaranteed to be "wealthy" and NEVER have to budget for things and consider finances, it's that physicians are pretty much guaranteed to make enough money (if managed properly) to live quite comfortably. And by comfortably I mean: affording a multi-bedroom house in a good neighborhood, eating out and enjoying entertainment regularly, affording vacations, and sending children to college. Maybe my experience is far too limited but I personally have not met a physician working full time that has not been/is not able to do those things.

 

[NontradCA]

The point is not that physicians are guaranteed to be "wealthy" and NEVER have to budget for things and consider finances, it's that physicians are pretty much guaranteed to make enough money (if managed properly) to live quite comfortably. And by comfortably I mean: affording a multi-bedroom house in a good neighborhood, eating out and enjoying entertainment regularly, affording vacations, and sending children to college. Maybe my experience is far too limited but I personally have not met a physician working full time that has not been/is not able to do those things.

What more could someone want?

 

[username456789]

The point is not that physicians are guaranteed to be "wealthy" and NEVER have to budget for things and consider finances, it's that physicians are pretty much guaranteed to make enough money (if managed properly) to live quite comfortably. And by comfortably I mean: affording a multi-bedroom house in a good neighborhood, eating out and enjoying entertainment regularly, affording vacations, and sending children to college. Maybe my experience is far too limited but I personally have not met a physician working full time that has not been/is not able to do those things.

Then again, keep in mind that most physicians you know did not suffer anywhere near the debt:income imbalance inherent with current medical students and very recent graduates.

One of my mentors who graduated residency in 1995 paid ~$40,000 total for his 4 years of medical school.

 

[DermViser]

The point is not that physicians are guaranteed to be "wealthy" and NEVER have to budget for things and consider finances, it's that physicians are pretty much guaranteed to make enough money (if managed properly) to live quite comfortably. And by comfortably I mean: affording a multi-bedroom house in a good neighborhood, eating out and enjoying entertainment regularly, affording vacations, and sending children to college. Maybe my experience is far too limited but I personally have not met a physician working full time that has not been/is not able to do those things.

Yes, ridiculously low level of medical school debt is quite nice. The ROI of school debt vs. salary was nice for ALL specialties.

 

[TXPMR]

Yes, ridiculously low level of medical school debt is quite nice. The ROI of school debt vs. salary was nice for ALL specialties.

Agree that the debt burden is greater with today's new crop of physicians (and I do think it's a serious issue in medical training). But even in light of this, all physicians (again. if money managed correctly) should be able to live very comfortably. Again, not super opulent and maybe not as crazy as our physician forefathers, but still among the top income earners in the country.

This is not to say though that we shouldn't fight Congress and Washington that wishes to cut physician compensation, more so to have perspective about our incomes and income potentials. Stressing out over a specialty that averages 500k/year and one that is 200k/year if that 200k/year is what someone loves and offers a better lifestyle. In that instance, the difference between 500k and 200k is marginal.

 

[DocEspana]

Edit: let me not feed the fire.

 

[a runner]

No. Thats compeltely false. First off you are isolating out the federal tax but excluding the federal PAYROLL tax (for god knows what reason, those two things are never considered together). Nearly 47% of the country OVERPAYED their federal income taxes through their bi-weekly payroll tax and thus when 'tax time' comes the government gives them back money since their income contribution outweighed their federal 'non-income' requirement. In reality, call it what it is. 47% of americans were too tax naive to realize they gave the government an interest-free loan that exceeded (often far exceeded) the amount they actually owed. 53% of us dont pay what we actually owe by tax time and have taxes due at the end of the year. And we will get to tax brackets in a second.

Actually what DermViser said is not false at all. He/she specifically said 47% pay no federal INCOME tax and said nothing about payroll tax. You changed the discussion to include payroll taxes, which is a separate program entirely, as are sales taxes and property taxes. Nobody is saying that 47% pay NO TAXES AT ALL. There is no possible way to tease out all the ways we are taxed. That $5 burger? You just paid part of the corporate taxes that business pays through the costs being passed on to you. You just paid part of the employer portion of the payroll tax. You just paid part of the property taxes on the building that serves the burger, not to mention the property taxes on the company's corporate headquarters building. You just paid part of the sales taxes that the burger joint paid for any supplies it uses. Not to mention sales taxes on the burger itself, which is easily visible and calculable.

The reason payroll taxes are considered separately are because they are "supposedly" paying towards your future retirement and there are caps on how much social security will pay. If you make $300k per year on average during your career, you are not going to get more in social security than the person who made $50k average over their career, so why should they pay so much more? That is why there is a cap at around $117k, and going up every year (even though the median income is stagnant at best).

And wow, you are actually the one who has it completely false. That 47% figure has nothing to do with overpaying on taxes during the year and receiving a refund at tax time. It has nothing to do with whether or not you get a refund. Like you said, refunds only have to do with whether or not you overpay or underpay during the year. This 47% figure is not referring to that, it is referring to the simple fact that when taxes are calculated after the end of the year (regardless of whether or not a person gets a "refund"), 47% of them owe $0 taxes. Not everyone who gets a refund owes $0 in taxes. You could have paid $2000 in federal income taxes during the year and at the end of the year your tax liability is only $1500, so you get a $500 refund. That DOES NOT mean you are in the 47%, you would in fact be in the 53% who paid taxes ($1500 to be precise). The 47% owe $0, absolutely nothing, nada, in federal income taxes, and most of them actually have a net gain in money because of refundable credits. It's really simple, isn't it?

 

[a runner]

Doesn't income tax apply to every job in existence? (It does)

Doesn't income tax impact high earners proportionally less than low earners, making doctors pay a lower % of their income than other fields? (it does, your rate of taxation drops above a certain income)

Doesn't loan repayment apply to pretty much any master/professional level degree (it does), which makes medicine the most lucrative of the high loan fields? (Unless your loan is from an *elite* business school and you become a chief officer at an usually lucrative business, physician will be by far the most lucrative)

Isn't it generally agreed that no other field with large loans can 'take advantage' of the PSLF to eliminate loans very prematurely to the level physician can? (It's such an agreed upon thing that the Fed uses doctors as a reason why they need to cut it back for everyone)

Aren't all of the income values you see online "post-" all of this stuff, and thus they represent the take home value* (they are*)

My point being... There are nearly no poor doctors. Just ones that get paid better than others. The conflict comes when the pediatrician feels he works harder than the ophthalmologist but gets paid 1/3 the money. Does t mean his 1/3 isn't objectively large. Only that the ophthalmologist makes silly good money for the work hours. Pay per hour and the potential for 1st percentile incomes are real factors. But I just dint think their that vital when the worst possible outcome is being in the 2nd percentile of earners in America.**

* obviously some do not include overhead and I could believe some might not include malpractice, but everything I've seen has been post tax and post benefits contribution and post malpractice. +/- personal business overhead since that does t apply to all fields or even all doctors in fields it can apply to.

** If you earn $150,000 you are in the 98th percentile of incomes in the US.

Federal income tax absolutely does NOT apply to many, many jobs in existence. Take a job paying $45,000 for a family of 4:
Tax liability (http://www.calcxml.com/calculators/federal-income-tax-calculator): $798
Earned income tax credit (http://www.bankrate.com/calculators/tax-planning/earned-income-tax-credit-calculator.aspx): -$706
Total tax liability: $90, or an effective tax rate of 0.2%

Compare that to someone making $250,000. Same situation, family of 4:
Tax liability: $51,706 (of course at this income, all tax credits have been phased out)
This is an effective tax rate of 20.7%

So, clearly you are absolutely wrong that income tax impacts high earners less than lower income earners as a proportion of income. The person who makes $45k pays 0.2% of their income vs. the person who makes $250k pays 20.7% of their income. And this doesn't even include other tax credits like the home mortgage or student loan interest deduction which would get the $45k person down to $0 (in fact, the $706 earned income tax credit is refundable, so they will take away a net profit of $706 if they use any credits to negate the $798 liability) and make them part of the 47%. Unfortunately the person making $250k won't be able to use any of these credits because they are all phased out at their income level and they will be stuck at the 20.7% rate.