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[Splenda88]

Personally, I prefer to make decent money at my state job, work business hours Mon-Fri, enjoy all state holidays off, and work towards my pension. I make plenty of money and I just want to enjoy my time off.

That's great. But there are some that like the idea of front loading their investment/retirement money and then work 2-3 days/wk until they completely retire

What I mean is that you work 60 hrs/wk for 7 yrs and invest/save 200k/yr and then cut back to 2-3 days/wk until retirement.

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[Splenda88]

If you don't LOVE psych, if you're not passionate about helping people with mental illnesses, including severe mental illnesses, don't do psych. You absolutely should not do psych if you're only interested in "money and lifestyle." The schedule for psych is generally good and you can certainly make a good living, but the work is DIFFICULT and requires a lot of emotional energy and a level of genuine interest I'm just not sensing from OP.

Why is that? People work jobs they don't like and still perform well....

 

[sloop]

That's great. But there are some that like the idea of front loading their investment/retirement money and then work 2-3 days/wk until they completely retire

What I mean is that you work 60 hrs/wk for 7 yrs and invest/save 200k/yr and then cut back to 2-3 days/wk until retirement.

Okay, what’s your point? I indicated that there are many different aways to work in my field. You can work a lot and make lots of money or work less and make less.

 

[OptionOffense]

I feel like gas makes more on average but in psych it's more of a choice. You can hang a shingle on your own basically anywhere, take no insurance, and make bank in psych still. Gas is 5-10 years from feeling saturation that will only get worse as the mid-level wave comes of age, and the slimy private equity guys circling around boomers' practices will only make that worse.

Psych makes less because a lot of people who choose to go into psych actively steer away from the big money activities because they are boring. That leaves opportunity open if money becomes a priority down the line.

this ^^^

 

[h23]

Why is that? People work jobs they don't like and still perform well....

Most people don't have to deal with the challenges of medicine. Psychiatry can be extremely demanding and not worth it if your personality doesn't mesh well with it. I know it gets said a lot around here, but if all you really care about is money and lifestyle, there's so many other career paths you could choose. My friends in computer science or UX are making such nice, amazing wages right now and don't have any of the stress I have to undergo by being in medicine. Let's just say that there's a reason physician suicide is as high as it is right now.

 

[ChordaEpiphany]

There is really no free lunch. It depends on how much you want to make and what you want your lifestyle to be. My salary is somewhere between $270K and $290K, for reference. Like I said, I basically work business hours Mon-Fri. I leave at the same time every day even if there is an admission because the admissions generally arrive earlier. I get all state holidays off and I don’t work weekends. I have good benefits and a pension plan. You can make a lot more but that is going to wind up involving either some weekends/overnights or significantly longer regular work hours. If you’re in a more rural area or a less saturated urban market you can probably make more, but I would not expect to make more than like low to mid 300s in most places (i.e. not like rural Alaska or something) and maintain a typical 9-5 or equivalent schedule.

Also, there is an in-between from living in the hospital and buying Ferraris and never working weekends/nights/holidays and just having one job. You can go moonlight at a hospital covering the ED and/or an inpatient unit. Depending on the gig, you can trade some of your weekends for extra income.

It all depends on what you value. You just can’t generally expect to just put in your 40 hrs a week and make boatloads of cash. I think this is probably the case for many specialties.

I think the free lunch is just relative. It's the overall position of the field, which allows high earning potential through exclusivity and objective societal value. No one appreciates free lunch because we all adjust our norms, take what we have for granted, and reach for more.

Go to a Wall Street forum and describe a dermatologist's training path, lifestyle, and earning potential. The PE guys would probably call it too much work for too little money. My brother-in-law is in financial regulation and people regard his path as a passion project analogous to peds. Dude makes $300k+ in his early 30s, WFH, and does 9-4 every day with so little to do he works out every day during work. He has been over $100k since leaving college with the only extra school a part-time, paid-for, elite MBA that he got into with a 3.8 GPA and a degree in econ from a very average college. He's nearly ready to retire. I'm not even through school. To high finance people, all of medicine is a $25 dry chicken sandwich with no sauce. Derm maybe has some aioli on the side.

Go to a welding forum and describe primary care and they'd call it a dream. They probably have discussions about certain pathways that'll earn you big money, but you have to be willing to live in a cave with bears covered in salmon for 35 weeks of the year. Oh and that big money salary is $250k and you age out in your late 30s. To welders, all of medicine is free lunch. Same probably goes for a ton of professions.

If you want free lunch you just have to close your eyes and forget what cardiology is making, or try to match an engineer's lifestyle with a physician's salary. There's your free lunch. You went medicine instead of engineering, and now you earn double for the same amount of work.

 

[Splenda88]

Most people don't have to deal with the challenges of medicine. Psychiatry can be extremely demanding and not worth it if your personality doesn't mesh well with it. I know it gets said a lot around here, but if all you really care about is money and lifestyle, there's so many other career paths you could choose. My friends in computer science or UX are making such nice, amazing wages right now and don't have any of the stress I have to undergo by being in medicine. Let's just say that there's a reason physician suicide is as high as it is right now.

Well, there isn't that MANY (emphasis on MANY). There has been many threads here on this topic. There is a reason why getting into med school is extremely competitive. If salary (and job security) suddenly are not good, I guarantee you people won't need 3.6+ GPA and 30+ MCAT to get in.

Look at RadOnc... 8+ yrs ago, you needed a PhD along with your MD to be competitive for that speciality and now they can't even fill up their spots... Emergency medicine is starting to suffer a similar faith.

Do you really believe when kids say they want to be doctor when they grow up they are thinking about Dermatology?

 

[Candidate2017]

Anesthesia vs Psych (outpatient) is generally:

early AM start vs. bankers' hours/set own schedule
call vs. no call
nights/weekends vs. no nights/weekends
450k baseline vs. 300k baseline
insurance/Medicaid vs. insurance/cash

hospital PJs/scrubs vs. own PJs (if telepsych) or actual clothes
OR vs. office
wheeled stool vs. comfy chair
can't eat/drink in OR vs. in office expresso machine
patients don't mind you checking stocks, doing puzzles vs. patients do mind

get yelled at by surgeons vs. get yelled at by patients
narcissists vs. borderlines
can't fire surgeons vs. can fire borderlines

patients don't talk vs. patients talk
patients asleep vs. you try not to fall asleep
don't use your drugs on yourself vs. don't sleep with your patients
worry about killing patients vs. worry about patients killing themselves
can revive overly sedated patients vs. call 911

midlevels think they can do your job vs. midlevels, social workers, the public think they can do your job
almost all patients want to be numbed vs. some patients want to be numbed
some patients demand controlled substances vs many patients demand controlled substances

public doesn't know you're a doctor vs. public doesn't know you're a doctor

 

[h23]

Well, there isn't that MANY (emphasis on MANY). There has been many threads here on this topic. There is a reason why getting into med school is extremely competitive. If salary (and job security) suddenly are not good, I guarantee you people won't need 3.6+ GPA and 30+ MCAT to get in.

Look at RadOnc... 8+ yrs ago, you needed a PhD along with your MD to be competitive for that speciality and now they can't even fill up their spots... Emergency medicine is starting to suffer a similar faith.

Do you really believe when kids say they want to be doctor when they grow up they are thinking about Dermatology?

my point was that in medicine you have to complete 4 years of undergrad, would have to do research and maybe might have to do post-bacc or a masters, 4 years of med school, 3-7 years of residency and 1-2 years of fellowship maybe and then you can make that nice attending salary. I have several friends who started making six figures after college, working in UX or software engineering. Others still make comfortable salaries. These opportunities may be available to some and may not be available to others. You decide if waiting how ever many years, plus the abuse of med school, residency, as well as attending life, and essentially being glorified customer service is worth whatever salary you're able to get after all that schooling. Yeah, med school's competitive for a reason. Maybe it's competitive because people only look at the end goal and not the pathway to get there. I could go on, but I'm pretty sure all of this has been said, so I'm going to stop derailing the conversation now.

In regards to the specialty, based on your reasons alone, I would just go anesthesia. You cited that you don't want to deal with certain patient types in psych i think right? Pretty sure that patient type is pretty prevalent in psych. At least in anesthesia, you can browse your phone while you have the surgeon next to you yell at you. Maybe midlevel creep won't be too horrible, who knows tbh.

 

[Taddy Mason]

I don't have time for any foolishness serious answers only please.

This response strongly tips the scales in favor of anesthesia.

 

[Dr Meow]

my point was that in medicine you have to complete 4 years of undergrad, would have to do research and maybe might have to do post-bacc or a masters, 4 years of med school, 3-7 years of residency and 1-2 years of fellowship maybe and then you can make that nice attending salary. I have several friends who started making six figures after college, working in UX or software engineering. Others still make comfortable salaries. These opportunities may be available to some and may not be available to others. You decide if waiting how ever many years, plus the abuse of med school, residency, as well as attending life, and essentially being glorified customer service is worth whatever salary you're able to get after all that schooling. Yeah, med school's competitive for a reason. Maybe it's competitive because people only look at the end goal and not the pathway to get there. I could go on, but I'm pretty sure all of this has been said, so I'm going to stop derailing the conversation now.

In regards to the specialty, based on your reasons alone, I would just go anesthesia. You cited that you don't want to deal with certain patient types in psych i think right? Pretty sure that patient type is pretty prevalent in psych. At least in anesthesia, you can browse your phone while you have the surgeon next to you yell at you. Maybe midlevel creep won't be too horrible, who knows tbh.

I think if someone was planning from the get go from high school to make the most money early on via investing, that would be good.
But unfortunately, life is Bayesian. The mistakes we make in our past affects our future and so future decisions need to take account the mistakes already made.

Hence, someone who already got a BS in Bio/chem/biochem is at a huge disadvantage. Even worse is a biochem major + many years working as a lab tech nontrad. It would be much worse to go back to school to get another BS degree in engineering or CS because those fields play by their own Agism rules and you get none of the early investing benefits from having an ok early salary which in a later age is terrible (w/o factoring in compounding)

So someone who is already positioned to be in the Doctor route, unknowingly taken, might as well finish it rather than be stuck perpetually as a lab tech lacky. In this route High Salary + Stability > moderate salary + limited Compounding.

 

[Mad Jack]

If you like procedural work and money, anesthesia. If you like talking to people and having you own business with no admin, psychiatry. You'll make a lot less in the average week in psych at this time but who knows what the future holds, so that is a factor. My peak earnings if I work myself damn near to the bone (every other weekend call with overnights) would be about what the average anesthesiologist makes working 60 hours in a M-F, but I could earn a larger chunk of change doing locums at the moment. AMCs seem to at least be waning in influence as venture capitalists can't deliver what they thought while still turning a profit. However, their eyes may come to settle on mental health services in the future.

The thing that made the decision easy for me was that the very thought of an add-on epidural in my morning made me hate my theoretical job, so anesthesia was clearly out. I just hate procedures.

 

[sillypsych]

Why is that? People work jobs they don't like and still perform well....

Because if you don't like it, you will be a bad psychiatrist. It's as simple as that. Psychiatry, more than any other specialty, requires the ability to care and continue caring about all of your patients, including the most difficult ones. You have to care about them even when they are truly doing everything in their power to make themselves hateful to you. And you have to be able to maintain this without getting depressed yourself. It is straight-up NOT possible to do all of this unless you genuinely love psychiatry. I have seen so many awful psychiatrists who just don't give a crap, either because they never cared (and just went into the field for "money and lifestyle") or because they couldn't take it and got burned out, and whose patients suffer as a result. (Not saying this doesn't happen with other specialties, but it's particularly bad in this field.) As a psychiatrist, you have access to your patients' deepest, most painful, most vulnerable thoughts, feelings, and experiences, and if you aren't interested and don't care, you will not do right by that, for them or for yourself.

 

[sloop]

but I could earn a larger chunk of change doing locums at the moment.

This is really the key in psych. If you’re just chasing a large salary, you should be doing locums. They make a ton more money and the salary can be pretty competitive with anesthesia. At a lot of places, the locums jobs are not even that unstable. Several of the locums at my job have been there for over a decade. I have a few reasons for not doing locums (PSLF, being sort of risk averse, preferring to have benefits through my job rather than have to deal with that all myself, etc.), but for the right person it is really great.

 

[sloop]

Because if you don't like it, you will be a bad psychiatrist. It's as simple as that. Psychiatry, more than any other specialty, requires the ability to care and continue caring about all of your patients, including the most difficult ones. You have to care about them even when they are truly doing everything in their power to make themselves hateful to you. And you have to be able to maintain this without getting depressed yourself. It is straight-up NOT possible to do all of this unless you genuinely love psychiatry. I have seen so many awful psychiatrists who just don't give a crap, either because they never cared (and just went into the field for "money and lifestyle") or because they couldn't take it and got burned out, and whose patients suffer as a result. (Not saying this doesn't happen with other specialties, but it's particularly bad in this field.) As a psychiatrist, you have access to your patients' deepest, most painful, most vulnerable thoughts, feelings, and experiences, and if you aren't interested and don't care, you will not do right by that, for them or for yourself.

Yeah, the biggest problem is that it is still very possible in many hospital environments to just IM people for looking at you the wrong way and keep them sedated to near unconsciousness. If you don’t like psychiatry or psych patients and are in it purely for an easy life, you are very likely to provide this type of terrible care.