DO seems way more competitive

[Gandyy]

Do you guys really think that DO aren't gonna be able to specialize after the merger?

No one knows. It's all speculation

---

Members don't see this ad.

 

[MightBeACylon439]

The problem is, it isn't your call to tell someone to change. We are all adults here.

If you can't follow the rules on this forum, then don't post. If you have a problem with the rules, then take it up with the forum moderators to change them.

1. It is absolutely my call to tell someone if they need to change, and as I have been saying...you need to change.
2. Most of us are adults, you are not.

 

[kenjixshadow]

Do you guys really think that DO aren't gonna be able to specialize after the merger?

No, we'll be fine. @AlteredScale, go slap some sense to your new bf.

 

[mathnerd88]

By blaming the ACA for falling physician salaries you are showing that you are out of touch again. Even with the ACA healthcare is enormously profitable and hospitals continue to make tons of money and are saturating neighborhoods with hospitals that are already full on their healthcare needs.

Corporate medicine is what is lowering physician salaries...and again if you believe that its the ACA then you are part of the problem.

ACA standardizes the cost of healthcare somewhat. Insurance companies will tend to follow.

 

[mathnerd88]

1. It is absolutely my call to tell someone if they need to change, and as I have been saying...you need to change.
2. Most of us are adults, you are not.

1. It isn't your call to insult someone. Forum rules already set it.
2. That's just your opinion. Mine is the opposite. There are plenty of other people who disagree with me but still treat me with respect. If you want someone to change, perhaps figure out another way. Because this isn't working between us. Sorry. You're going to have to figure this out when you have patients.

 

[BorntobeDO?]

Where did this thread go wrong? I searched for ways to get A's in DO school and this stupid thread came up. And like a car wreck I can't take my eyes off it... Clearly the way to get A's is to admit more students who think the average wage of all physicians is 160k, and that correcting blatantly bad advice based on even more laughable 'google research' is mean.

By blaming the ACA for falling physician salaries you are showing that you are out of touch again. Even with the ACA healthcare is enormously profitable and hospitals continue to make tons of money and are saturating neighborhoods with hospitals that are already full on their healthcare needs.

Corporate medicine is what is lowering physician salaries...and again if you believe that its the ACA then you are part of the problem.

Truer words have rarely been spoken. Big med management companies will half our salaries in the future. Not the ACA.

 

[MightBeACylon439]

ACA standardizes the cost of healthcare somewhat. Insurance companies will tend to follow.

Yes and they will still be forced to make reimbursements, with the aging population and more reimbursements being made (albeit the reimbursements individually may be less) hospitals will continue to make money, and they will do it very well. If physician salaries stagnate or fall, it will be because of corporate pay scales and not the ACA.

 

[BorntobeDO?]

Do you guys really think that DO aren't gonna be able to specialize after the merger?

Not yet. That will take about 10-20 years before it starts becoming a wide phenomena. I don't believe the match will be unified till 2020 anyhow.

Ironically enough, IMO the expansion of DO may actually help by then because with so many of us it would be pretty hard for ACGME to keep all DO's from certain types of residency. We could probably steal back a sizable portion of GME at that point if it came down to it. In 20 years with the rate DO schools are going we would be like half of residency applicants. If you tell half the people available they can't get into anything but primary care residency, something will give.

 

[mathnerd88]

Yes and they will still be forced to make reimbursements, with the aging population and more reimbursements being made (albeit the reimbursements individually may be less) hospitals will continue to make money, and they will do it very well. If physician salaries stagnate or fall, it will be because of corporate pay scales and not the ACA.

So you're saying ACA does not influence physician salaries at all?

My hospital is non-profit, so not sure how that factors in.

 

[MightBeACylon439]

1. It isn't your call to insult someone. Forum rules already set it.
2. That's just your opinion. Mine is the opposite. There are plenty of other people who disagree with me but still treat me with respect. If you want someone to change, perhaps figure out another way. Because this isn't working between us. Sorry. You're going to have to figure this out when you have patients.

It is absolutely my call when to insult someone, and with you I do it because you need it. Do not mistake other's dealing with you as a sign of respect, if they are like me when you first appeared on these forums they are leaving it be because its easier to ignore you and placate you than deal with the idiocy that results if they do not.

 

[Hustler101]

Dude you don't need to get so aggressive man. Let's just agree to disagree. Don't overstress yourself just to prove yourself right (because you aren't completely right.) Take a breath.

Again, your views make you sound very closed minded that being a physician is the only worthwhile high paying job out there. Just a hint: it isn't. Your views make you sound like you really don't know what other successful jobs there are out there. There are already thousands of positions in healthcare alone that pay a lot.

In my town, the median income is over $130k. Guess how many percentage of the upper 50%are doctors? Not very much. Your closeminded views make you seem like the only way to go is physician.

Btw, a PA is a very high paying job and have much less schooling and less working and studying hours than doctors do, so don't try your whole "PA's get paid a lot less than doctors." They're average hourly wage is around $60 an hour.

You want to spend 4 years in medical school, 4 years in residency that pays you little, and then hopefully come out making average of $160k after 8 years? Fine go ahead. Almost every single doctor I talked to told me it isn't as glamorous as lots of people make it out to be. Even one of the physicians told me that his interviewer kept complaining on how little he is making and how much loans he owes. I've never met one doctor who said, the pay is amazing! You should totally become a physician for the money.

I'm just being realistic here. The longer years you are out of school the less money you are really making. I'm not saying oh doctors will forever be in debt and that you'll never be successful. My point here is that people need to be realistic and that it won't be an amazing lifestyle as some other professions from the start. You clearly don't recognize that. The truth is, the healthcare system is changing. We still haven't felt the full effects of Obamacare. I've been talking to physicians already and their salaries are already being decreased from Obamacare. There is still a LOT of uncertainty with the healthcare system going on right now. We are pretty much the beta-testers of the new healthcare plan.

We have the recent AOA ACGME merger, (which I suspect is a way for them to make even more money.) Truth is, we can't say for sure what happens to the future of physicians. All I know is historically, when the economy is doing very well, there are a lot less applications for medical school. Why do you think that is?

wha... ?

130k is a ridiculously high income for a median... most people make 30-50k tops.

You want to try anecdotes? I know plenty of docs who are very happy with the money. Know of ones making in the 400-500 range without working insane hours. There are also plenty making well over 500.

Medicine is by far the best field to go into for money. No other fields come even close to it.

 

[mathnerd88]

wha... ?

130k is a ridiculously high income for a median... most people make 30-50k tops.

You want to try anecdotes? I know plenty of docs who are very happy with the money. Know of ones making in the 400-500 range without working insane hours. There are also plenty making well over 500.

Medicine is by far the best field to go into for money. No other fields come even close to it.

Then if that was the case, why is the average listed only $190k? You're saying you know physicians making 400-500 range and plenty making well over 500...well, then why is the average only $190k reported?

 

[MightBeACylon439]

So you're saying ACA does not influence physician salaries at all?

My hospital is non-profit, so not sure how that factors in.

It will only because administration and corporate statements will play off the fear of what the ACA might do, all the while their salaries will continue to rise. There could be problems where payments from medicare/medicaid are jacked up and so people hospital wide don't get raises, but this has happened in Arizona years before the ACA was even in effect so blaming the ACA would again just be forgetting historical problems with the system for political gain.

 

[Hustler101]

Lol...you were quoting average emergency physicians. Sorry to burst your bubble, but most DO's go into primary care.

Family medicine physicians make $78 an hour.

Be a family doctor and see 45 patients a day. See how much you make.

 

[BorntobeDO?]

Then if that was the case, why is the average listed only $160k? You're saying you know physicians making 400-500 range and plenty making well over 500...well, then why is the average only $160k reported?

http://www.medscape.com/features/slideshow/compensation/2015/public/overview#page=2

This is a reliable source. Notice that the average primary care is 195k, and 284k for specialists. With over 19000 responses. That is what we like to call a significant sample size.

 

[Hustler101]

Then if that was the case, why is the average listed only $160k? You're saying you know physicians making 400-500 range and plenty making well over 500...well, then why is the average only $160k reported?

Take away people who:

1) work part time

2) work too slow

3) work in academics (teach/do research)

4) don't orient their practice towards maximum revenue

5) don't work fast

6) work <50 hours/week

Then see what the "average" is... Those averages often include resident income too and reported incomes are always all over the place in medicine. Or go up to Canada where family doctors make way more than in the US. Or do cosmetics. There are a link to a site posted of a family doc who does hair transplant full time.

 

[mathnerd88]

Take away people who:

1) work part time

2) work too slow

3) work in academics (teach/do research)

4) don't orient their practice towards maximum revenue

5) don't work fast

6) work <50 hours/week

Then see what the "average" is... Those averages often include resident income too and reported incomes are always all over the place in medicine. Or go up to Canada where family doctors make way more than in the US.

Okay, understood. I guess that makes sense.

 

[kenjixshadow]

http://www.medscape.com/features/slideshow/compensation/2015/public/overview#page=2

This is a reliable source. Notice that the average primary care is 195k, and 284k for specialists. With 19000 responses. That is what we like to call a significant sample size.

MGMA data is even more reliable, but you'll have to pay to get it. I believe the salaries will stay the same or even go up a little. Supply and demand. American populations demand more faster and advanced healthcare. We'll be there to provide and don't forget baby boomer docs are retiring.

 

[mathnerd88]

It will only because administration and corporate statements will play off the fear of what the ACA might do, all the while their salaries will continue to rise. There could be problems where payments from medicare/medicaid are jacked up and so people hospital wide don't get raises, but this has happened in Arizona years before the ACA was even in effect so blaming the ACA would again just be forgetting historical problems with the system for political gain.

So you believe ACA will just fatten the pockets of everyone else but physicians?

 

[BorntobeDO?]

MGMA data is even more reliable, but you'll have to pay to get it. I believe the salaries will stay the same or even go up a little. Supply and demand. American populations demand more faster and advanced healthcare. We'll be there to provide and don't forget baby boomer docs are retiring.

I agree. I would guess that the numbers are higher there, as I think physicians tend to softball the public surveys, and there is probably quite a bit of part time/academics inclusion in those numbers. PS for anecdotal. I have a friend in residency as a FM doc who is going to moonlight at a pain clinic (prescrbing Buprenorphine) for 150-160 a hour. Also has an offer for a IM job for 220k + bonus. Nobody makes 160k unless they want too.

 

[Hustler101]

Okay, understood. I guess that makes sense.

Average incomes suck in medicine when it comes to accuracy. Most family docs work slow and don't see enough patients and a lot of specialists do academic/admin stuff. If you're entirely focused on making the most money and nothing else it's an entirely different world. You could almost double the averages at that point.

 

[mathnerd88]

Average incomes suck in medicine when it comes to accuracy. Most family docs work slow and don't see enough patients and a lot of specialists do academic/admin stuff. If you're entirely focused on making the most money and nothing else it's an entirely different world. You could almost double the averages at that point.

True. I guess I'm only involved with physicians in academia so I have a skewed viewpoint.

 

[MightBeACylon439]

So you believe ACA will just fatten the pockets of everyone else but physicians?

ACA won't fatten anyone's pockets, its not what it was designed to do. What will fatten hospital administration's pockets (not "everyone else"- maybe you should read my post again) is the fact that they still will be making lots of money from government/insurance reimbursements and instead of increasing physician salaries (and everyone elses salaries that works for the hospital) at a rate comparable to the rate at which they raise their salaries, they will give themselves meteoric raises...and everyone else 1-3% yearly.

 

[Stagg737]

I love watching pre-meds argue, LOL. Anyway, addressing some points.

Well, some people even have to add on their college loans to that...so that's something else to consider. I know someone who owes over $500k in loans just from college and graduate school.

Unless your friend was guaranteed to be making 400-500k/year straight out of college he was a *****. No offense, but at some point someone should cut those people off.

Concerned how? I will admit my end goal is to be an ER doctor. If this merger works in some negative way where most DO's are forced in primary care, I don't know what I'd do. Although I believe in some contexts ER doctors are considered primary care.

ER docs are considered to be primary care by most. Primary care typically entails family, internal, OB/GYN, psych, and EM (someone can help me out if I missed one). Apparently some places are even beginning to consider gen surg to be PC, but that's recent news to me.

Do you guys really think that DO aren't gonna be able to specialize after the merger?

It will likely be more difficult in some of the more competitive fields, but DOs will still be able to specialize. It all depends on how fast this merger happens and what the standards actually end up being...

Not yet. That will take about 10-20 years before it starts becoming a wide phenomena. I don't believe the match will be unified till 2020 anyhow.

A COCA board member recently talked to us and he disagrees with that statement. According to him there may be a unified match as early as 2018, but he was pretty certain it would happen by 2019. Additionally, I think it'll be easier for DO's to specialize in 20 years than it is now. Other than a few schools, the average stats for DOs, including board scores are steadily rising and getting slightly closer to MD scores. I think once the merger happens and ACGME programs start seeing better DO candidates that they previously shut out (because letters), it will even the playing field more.

wha... ?

130k is a ridiculously high income for a median... most people make 30-50k tops.

You want to try anecdotes? I know plenty of docs who are very happy with the money. Know of ones making in the 400-500 range without working insane hours. There are also plenty making well over 500.

Medicine is by far the best field to go into for money. No other fields come even close to it.

Depends on how you define that. If you're talking yearly salary, then generally speaking yes. If you're talking hourly pay rate then no. Also, the people making 400-500k/year are either very rare, pretty old, or working significant overtime (10+ hours per week). Most new physicians will make 250k or less unless they're in a high-paying specialty or working a ton of hours.

 

[mathnerd88]

I knew something was fishy with people knowing doctors who make $400-500k per year.
I didn't think they were common either.

My sister is an anesthesiologist and makes nowhere near that.

 

[Stagg737]

Average incomes suck in medicine when it comes to accuracy. Most family docs work slow and don't see enough patients and a lot of specialists do academic/admin stuff. If you're entirely focused on making the most money and nothing else it's an entirely different world. You could almost double the averages at that point.

If you're entirely focused on making the most money then you have no business being in medicine, or seeing patients at the very least.

 

[mathnerd88]

If you're entirely focused on making the most money then you have no business being in medicine, or seeing patients at the very least.

Which is what I was thinking all along. Being a doctor still pays well, but other professions can potentially pay more without that much effort, schooling, and dedication.

 

[BorntobeDO?]

I knew something was fishy with people knowing doctors who make $400-500k per year.
I didn't think they were common either.

My sister is an anesthesiologist and makes nowhere near that.

You sister is doing mommy track/competitive location, or isn't trying to make that. Its definitely still out there if she wants it.

Actually I take it back. I like gas. So the CRNA's are coming! the pay sucks, everyone else do something else!

 

[mathnerd88]

You sister is doing mommy track/competitive location, or isn't trying to make that. Its definitely still out there if she wants it.

Let's just put it this way. She was offered in the $300k+ range in private practice. Once you take away malpractice, health insurance, all other expenses, it ended up being much lower and same as if she worked in a hospital.

And yes, she wants to be in a desirable location.

 

[kenjixshadow]

x

 

[BorntobeDO?]

Let's just put it this way. She was offered in the $300k+ range in private practice. Once you take away malpractice, health insurance, all other expenses, it ended up being much lower and same as if she worked in a hospital.

And yes, she wants to be in a desirable location.

Those things always come out. Her salary was still over 300k. It is uncommon to have 400k after taxes/expenses, but its not uncommon/unheard of for anesthesia to make over 400k before those things.

 

[kalat]

There's a lot of ambiguity in a lot of the claims in this thread. The financial aspects in particular can be fleshed out fairly easily (especially loan and interest amounts since they are usually fixed) and there's not much you really need to venture out to estimate other than your future salary. The reality of the future salary is you will not know it until its a present salary, but any guesses are most likely best left to the physician compensation report which, while it has its critics, is probably the most reasonable approximation we have of average current wages (read: not a forecast of future wages) which are indicative of future wages especially considering it allows you to follow yearly changes.

With all that said, I will take the time to flesh out an example of a full overview of a repayment plan using a conservative future salary so we can dispel any myths about the loan amounts and the repayments. This is something anyone can do in their free time, but I know most people will not, and I hope this helps in the future as people are weighing their options on whether medical school is worth it financially. For the record, these are real numbers I've used for my school and my reasonable approximation of my specialty. I recommend everyone entering any medical school do this before you even think about attending. How could you leave something like this to your imagination?

There are five repayment options: Standard, Graduated, Extended, IBR (Income Based), and PAYE (Pay As You Earn). My variables are: Residency/Fellowship (4 years), Amount Borrowed ($266,608 total), Residency Salary ($59,000 - $4,917/monthly), and Post Residency Salary ($215,000 - $17,917/monthly). The amount borrowed is made up of both Stafford-Unsubsidized (6.21% interest) and Grad PLUS - FFEL (8.5%) loans. Keep in mind these are relatively lax 10-25 year repayment plans which will be letting you keep most of your salary. If you're planning on living on only 30% of your income for a few years the whole situation changes.

Spoiler: Click to View Repayment Overview

Standard Repayment

Total paid over the life of the loan: $442,058 ($175,450 interest accrued)
Monthly payment during residency: $0
Monthly payment after residency: $3,684 (21% of monthly income)
Total repayment years (including residency): 10

Graduated Repayment

Total paid over the life of the loan: $456,803 ($190,195 interest accrued)
Monthly payment during residency: $0
Monthly payment after residency (years 0-1): $1,861 (10% of monthly income)
Monthly payment after residency (years 2-10): $4,293 (24% of monthly income)
Total repayment years (including residency): 10

Extended Repayment

Total paid over the life of the loan: $675,592 ($408,984 interest accrued)
Monthly payment during residency: $0
Monthly payment after residency: $2,252 (13% of monthly income)
Total repayment years (including residency): 25

Income Based Repayment

Total paid over the life of the loan: $677,632 ($411,024 interest accrued)
Monthly payment during residency: $496-647 (10-13% of monthly residency income)
Monthly payment after residency: $2,426-3,684 (14% of monthly income)
IBR Forgiven: $0
PSLF Forgiven: $307,711
Total repayment years (including residency): 21

Pay As You Earn Repayment

Total paid over the life of the loan: $426,670 ($406,051 interest accrued)
Monthly payment during residency: $330-431 (7-9% of monthly residency income)
Monthly payment after residency: $1,617-2,636 (9-15% of monthly income)
PAYE Forgiven: $338,371
PSLF Forgiven: $388,505
Total repayment years (including residency): 20

Take from that what you will, but it doesn't look particularly to bad me considering the amount of income you're still holding on to every month. In fact, you can speed up the process by paying the free money you have left over back into the loans! However, the IBR and PSLF seem a little iffy to me considering the questionable longevity of the programs, but it's a trade off for lower monthly payments. Regardless, you're going to be far from destitute, and eventually it's going to be pure profit.

 

[BorntobeDO?]

Which is what I was thinking all along. Being a doctor still pays well, but other professions can potentially pay more without that much effort, schooling, and dedication.

Very wrong. Just very very wrong. If you think it doesn't take much effort or dedication to get ahead in business... Just do it. Go out and fail with 90% of small business in the first 5 years while working 80+ hours a week just to go bankrupt. The people who get ahead in the business world are tenacious. Physicians could use a bit more of that ourselves. We wouldn't be getting killed by big med management groups and hospitals if we had it.

 

[Stagg737]

Don't say this in EM forum, you'll upset many attendings and you're missing Ped.

I know, it's like primary care is a swear, I really don't get it. I will say I'm not thrilled that EM seems to be getting more competitive lately though. And yes, thank you for catching Peds for me, I knew I was missing something.

Those things always come out. Her salary was still over 300k. It is uncommon to have 400k after taxes/expenses, but its not uncommon/unheard of for anesthesia to make over 400k before those things.

Depends on what you consider 'uncommon'. Average anesthesiologist salary is closer to 300k, but there are plenty of them out there pulling in 400k+.

 

[MightBeACylon439]

Very wrong. Just very very wrong. If you think it doesn't take much effort or dedication to get ahead in business... Just do it. Go out and fail with 90% of small business in the first 5 years while working 80+ hours a week just to go bankrupt. The people who get ahead in the business world are tenacious. Physicians could use a bit more of that ourselves. We wouldn't be getting killed by big med management groups and hospitals if we had it.

Lol @HandsomeRob, he will have ignored most of your post and rehash some other tired argument while pointing out that somehow you "completely missed his point."

 

[BorntobeDO?]

I know, it's like primary care is a swear, I really don't get it. I will say I'm not thrilled that EM seems to be getting more competitive lately though. And yes, thank you for catching Peds for me, I knew I was missing something.



Depends on what you consider 'uncommon'. Average anesthesiologist salary is closer to 300k, but there are plenty of them out there pulling in 400k+.

I would bet that at least a 3rd are over 400k. Thats not uncommon IMO.

 

[Buckeye1992]

If you really think the merger is going to cause DOs to be forced into primary care you're an idiot.

 

[kenjixshadow]

I know, it's like primary care is a swear, I really don't get it. I will say I'm not thrilled that EM seems to be getting more competitive lately though. And yes, thank you for catching Peds for me, I knew I was missing something.

B/c of $$$, shift work, and burnout -- you rarely find any EPs go full time after age 50 = jobs available.

 

[Buckeye1992]

EM isn't really that competitive. It's average at best. An average usmle score will get you a residency.

 

[FutureD0C17]

It will likely be more difficult in some of the more competitive fields, but DOs will still be able to specialize. It all depends on how fast this merger happens and what the standards actually end up being...

A COCA board member recently talked to us and he disagrees with that statement. According to him there may be a unified match as early as 2018, but he was pretty certain it would happen by 2019. Additionally, I think it'll be easier for DO's to specialize in 20 years than it is now. Other than a few schools, the average stats for DOs, including board scores are steadily rising and getting slightly closer to MD scores. I think once the merger happens and ACGME programs start seeing better DO candidates that they previously shut out (because letters), it will even the playing field more.

Agreed. This is a long term play from the DO world. Short term, I think the students are going to lose, possibly big, with the continual increase in enrollment and stagnant residency spots. LOTS of uncertainty and these DO schools continue to raise tuition and increase class sizes...it feels like a cash grab

 

[BorntobeDO?]

If you really think the merger is going to cause DOs to be forced into primary care you're an idiot.

This will be fun to look at in 10 years. We will see if the amount of DO's in primary care goes up or down. I will be curious. The amount will definately go up, and I would bet the percentage will also.

B/c of $$$, shift work, and burnout -- you rarely find any EPs go full time after age 50 = jobs available.

I think ER is best in rural locations. Thats what I would do if I went into it. The more urban you are the more homeless/drugseekers/headaches you get IMO.

 

[mathnerd88]

There's a lot of issues with some of the claims made in this thread. The financial aspects in particular can be fleshed out fairly easily (especially loan and interest amounts since they are usually fixed) and there's not much you really need to venture out to estimate other than your future salary. The reality of the future salary is you will not know it until its a present salary, but any guesses are most likely best left to the physician compensation report which, while it has its critics, is probably the most reasonable approximation we have of average current wages (read: not a forecast of future wages) which are indicative of future wages especially considering it allows you to follow yearly changes.

With all that said, I will take the time to flesh out an example of a full overview of a repayment plan using a conservative future salary so we can dispel any myths about the loan amounts and the repayments. This is something anyone can do in their free time, but I know most people will not, and I hope this helps in the future as people are weighing their options on whether medical school is worth it financially. For the record, these are real numbers I've used for my school and my reasonable approximation of my specialty. I recommend everyone entering any medical school do this before you even think about attending. How could you leave something like this to your imagination?

The first thing you need to know is there are five repayment options: Standard, Graduated, Extended, IBR (Income Based), and PAYE (Pay As You Earn). My variables are: Residency/Fellowship (4 years), Amount Borrowed ($266,608 total), Residency Salary ($59,000 - $4,917/monthly), and Post Residency Salary ($215,000 - $17,917/monthly). Keep in mind the amount borrowed is made up of both Stafford-Unsubsidized (6.21% interest) and Grad PLUS - FFEL (8.5%), and payments during residency may vary depending on your financial comfort level at that point.


With that said, these are standard repayments should you feel the need to have as much money as you need every year during these 10 years. If you pay more at any time the timeline shrinks (e.g. if you start making more money or spending less elsewhere), but as much as everyone says they're going to pay their loans off immediately, most are probably following these plans.

That's very informative, thank you! 10 years to repay back a loan at about $4k per month is pretty significant.

 

[FutureD0C17]

EM isn't really that competitive. It's average at best. An average usmle score will get you a residency.

Are you speaking as a MD or DO candidate? A solid DO student made a thread here not too long ago explaining how he had to SOAP into family med with above average everything. Nothing is guaranteed.

 

[BorntobeDO?]

Agreed. This is a long term play from the DO world. Short term, I think the students are going to lose, possibly big, with the continual increase in enrollment and stagnant residency spots. LOTS of uncertainty and these DO schools continue to raise tuition and increase class sizes...it feels like a cash grab

I am just glad I still feel like I have a decent chance at mid range specialties. It would suck to be like the Caribbean and have basically five choices (Bad IM program, FM, Peds, Path, OBGYN).

 

[Stagg737]

I would bet that at least a 3rd are over 400k. Thats not uncommon IMO.

You're actually closer than I thought:
http://www.medscape.com/features/slideshow/compensation/2013/anesthesiology

If you look at the hours though, only 27% are working 40 hours or less and over 40% work more than 50 hours per week.

B/c of $$$, shift work, and burnout -- you rarely find any EPs go full time after age 50 = jobs available.

Interesting point about the burnout. I've never looked at it that way, but that's an interesting thought.

EM isn't really that competitive. It's average at best. An average usmle score will get you a residency.

10 years ago it wasn't considered competitive, but not it's pretty much in the middle of the pack in terms of competitiveness. Yes, you can be average to get into a program, but that doesn't mean you'll get into a good one by any means.

 

[Hustler101]

If you're entirely focused on making the most money then you have no business being in medicine, or seeing patients at the very least.

What about making the most money possible while providing a good standard of care?

 

[Hustler101]

Which is what I was thinking all along. Being a doctor still pays well, but other professions can potentially pay more without that much effort, schooling, and dedication.

The thing is that your statement isn't even remotely close to the truth. It's actually the complete opposite of it.
Have you ever had a successful business? Ever looked at a very typical pharmacist, engineer, accountant, IB, etc. ? They make less than half of what a decent doc makes.

 

[BorntobeDO?]

There's a lot of ambiguity in a lot of the claims in this thread. The financial aspects in particular can be fleshed out fairly easily (especially loan and interest amounts since they are usually fixed) and there's not much you really need to venture out to estimate other than your future salary. The reality of the future salary is you will not know it until its a present salary, but any guesses are most likely best left to the physician compensation report which, while it has its critics, is probably the most reasonable approximation we have of average current wages (read: not a forecast of future wages) which are indicative of future wages especially considering it allows you to follow yearly changes.

With all that said, I will take the time to flesh out an example of a full overview of a repayment plan using a conservative future salary so we can dispel any myths about the loan amounts and the repayments. This is something anyone can do in their free time, but I know most people will not, and I hope this helps in the future as people are weighing their options on whether medical school is worth it financially. For the record, these are real numbers I've used for my school and my reasonable approximation of my specialty. I recommend everyone entering any medical school do this before you even think about attending. How could you leave something like this to your imagination?

There are five repayment options: Standard, Graduated, Extended, IBR (Income Based), and PAYE (Pay As You Earn). My variables are: Residency/Fellowship (4 years), Amount Borrowed ($266,608 total), Residency Salary ($59,000 - $4,917/monthly), and Post Residency Salary ($215,000 - $17,917/monthly). Keep in mind the amount borrowed is made up of both Stafford-Unsubsidized (6.21% interest) and Grad PLUS - FFEL (8.5%), and payments during residency may vary depending on your financial comfort level at that point.


Take from that what you will, but it doesn't look particularly bad for essentially paying minimums every month. The IBR and PSLF seem a little iffy to me considering the questionable longevity of the programs, but it's a trade off for lower monthly payments.

Good post. I agree that going into medicine you should plan to take 10 years to pay back the loans (unless primary care, then 20 with PAYE). It will be very hard to tell your spouse and family that they still have to live like paupers even tho your income after probably 9 years finally went up.

 

[Stagg737]

What about making the most money possible while providing a good standard of care?

Well obviously. Tbh though, if I were in something like FM I'd rather make 200k/year and be able to spend 20-30 minutes with each patient than make 250k/year and spend less than 10 minutes with each patient. Not just for the patient's sake, but because I would enjoy my job much, much more, which is worth that 50k to me in the long run.

There's a lot of ambiguity in a lot of the claims in this thread. The financial aspects in particular can be fleshed out fairly easily (especially loan and interest amounts since they are usually fixed) and there's not much you really need to venture out to estimate other than your future salary. The reality of the future salary is you will not know it until its a present salary, but any guesses are most likely best left to the physician compensation report which, while it has its critics, is probably the most reasonable approximation we have of average current wages (read: not a forecast of future wages) which are indicative of future wages especially considering it allows you to follow yearly changes.

With all that said, I will take the time to flesh out an example of a full overview of a repayment plan using a conservative future salary so we can dispel any myths about the loan amounts and the repayments. This is something anyone can do in their free time, but I know most people will not, and I hope this helps in the future as people are weighing their options on whether medical school is worth it financially. For the record, these are real numbers I've used for my school and my reasonable approximation of my specialty. I recommend everyone entering any medical school do this before you even think about attending. How could you leave something like this to your imagination?

There are five repayment options: Standard, Graduated, Extended, IBR (Income Based), and PAYE (Pay As You Earn). My variables are: Residency/Fellowship (4 years), Amount Borrowed ($266,608 total), Residency Salary ($59,000 - $4,917/monthly), and Post Residency Salary ($215,000 - $17,917/monthly). The amount borrowed is made up of both Stafford-Unsubsidized (6.21% interest) and Grad PLUS - FFEL (8.5%) loans. Keep in mind these are relatively lax 10-25 year repayment plans which will be letting you keep most of your salary. If you're planning on living on only 30% of your income for a few years the whole situation changes.

This is solid, only thing I'd say is to drop that resident pay from 59k to 49k. I don't know any residencies other than military ones with a base pay over 55k, and the ones over 50k are in fields that work you to the bone like ortho.

 

[Hustler101]

Depends on how you define that. If you're talking yearly salary, then generally speaking yes. If you're talking hourly pay rate then no. Also, the people making 400-500k/year are either very rare, pretty old, or working significant overtime (10+ hours per week). Most new physicians will make 250k or less unless they're in a high-paying specialty or working a ton of hours.

The problem with this is that private practices vary. If you structure your practice towards maximum revenue you'll get a far different outcome than if you just do the typical bread and butter stuff in your field.
It's not all about hours but also about efficiency. More patients per time = more revenue. But you need the skills to maintain a standard of care.

Also 400k-500k is nottt "very rare." There are physicians making over a million a year... spine surgeons averaged at 1 mil/year a few years ago. I would classify making well over 1 mil a year as being "very rare." There are also docs making 3-20 million.