help, going into consulting and not doing residency

[gonogo]

I hope this is the right place where to post. I am almost done with my MD/PhD. Assuming I start residency next year, in some months I will be sending applications for residency. However, I am pondering not doing a residency. I am fairly tired of school and going through 5 more years of training, not getting paid well, seems pretty discouraging to me right now. I have of the possibility of going into consulting, where I can potentially start with a pretty decent salary and eventually go up the ladder. Now, here is the question: in terms of money, which of these two paths would be more rewarding (by rewarding here I mean more money)? I am very curious to know how is the salary of a physician compared to someone who is more in the business sector with some advance degree. I know it can vary a lot from person to person, but let's put it this way, which path has the most potential for one to get a very good salary.

I will appreciate any input.

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[Sir William Osler]

you wont get a good answer to that question. the money shouldn't be the deciding factor. where do you see yourself in 10 years? Are you a businessman or a doctor? figure that out and then you have your answer.

 

[Taurus]

I hope this is the right place where to post. I am almost done with my MD/PhD. Assuming I start residency next year, in some months I will be sending applications for residency. However, I am pondering not doing a residency. I am fairly tired of school and going through 5 more years of training, not getting paid well, seems pretty discouraging to me right now. I have of the possibility of going into consulting, where I can potentially start with a pretty decent salary and eventually go up the ladder. Now, here is the question: in terms of money, which of these two paths would be more rewarding (by rewarding here I mean more money)? I am very curious to know how is the salary of a physician compared to someone who is more in the business sector with some advance degree. I know it can vary a lot from person to person, but let's put it this way, which path has the most potential for one to get a very good salary.

I will appreciate any input.

The answer is "it depends". I was a consultant for many years and I have a pretty good idea of what it takes to succeed. If you want to go far in consulting, there are two important skills to have:

1) Leadership, management, and buttkissing abilities

This is very important when you're climbing the ladder. You will be charged with overseeing people below you to deliver what you promised the client. You'll have to kiss as much ass as you can to the people above you.

2) Sales

This is the most important skill if you want to become partner. You can be the low-life of human kind and have no people skills, but if you can sell millions of dollars worth of work, you'll make partner.

You can be a genius in science, but if you don't have these two things, you won't go very far.

Back to studying.

 

[gonogo]

you wont get a good answer to that question. the money shouldn't be the deciding factor. where do you see yourself in 10 years? Are you a businessman or a doctor? figure that out and then you have your answer.

Thanks for your comment. I understand that the money should not be the deciding factor, but I am now doing a list with the pros and cons of each path, and I have to admit that money is important for me, so I have to put it in the list. I just want to have a clearer idea of whether it is valid to say that either way the pay is similar in the end, or if it is a more fair assumption to say that one thing is much more profitable than the other.

 

[gonogo]

The answer is "it depends". I was a consultant for many years and I have a pretty good idea of what it takes to succeed. If you want to go far in consulting, there are two important skills to have:

1) Leadership, management, and buttkissing abilities

This is very important when you're climbing the ladder. You will be charged with overseeing people below you to deliver what you promised the client. You'll have to kiss as much ass as you can to the people above you.

2) Sales

This is the most important skill if you want to become partner. You can be the low-life of human kind and have no people skills, but if you can sell millions of dollars worth of work, you'll make partner.

You can be a genius in science, but if you don't have these two things, you won't go very far.

Back to studying.

Taurus, your comment has been pretty helpful. Now, let's assume I have those skills you mention, or rather, that I am able to develop them through my first year as consultant. In the long term, based of what you've seen in the consulting world, how is life quality? How would you compare it to being a doctor?

 

[Taurus]

Taurus, your comment has been pretty helpful. Now, let's assume I have those skills you mention, or rather, that I am able to develop them through my first year as consultant. In the long term, based of what you've seen in the consulting world, how is life quality? How would you compare it to being a doctor?

Again, the answer is "it depends" on what your idea of a good quality of life is.

As a partner, you are responsible for sales and keeping clients happy. You woo them with dinners, baseball games, strip clubs, etc. You'll pretty much do anything to keep that $40 million account. If someone junior screws up and jeopardizes the account, you get rid of him. If you have competent senior managers overseeing the day-to-day work, it's not that much work. If you have many existing or prospective clients scattered across the country, you may be in one city on Monday and a different city on Wednesday, week in, week out. You can expect to be on the road 100% of the time. It's not all bad. You stay in nice hotels, drive nice rentals, eat nice dinners, and you get to enjoy the nightlife of that city. The money is great. Partners can make between $300k to $1 million at large firms.

Let's not get ahead of ourselves here. Making partner is not easy at all and there's no guarantee at all like there is if you finish residency and become an attending. If you think you've got what it takes to be partner, then consulting is attractive alternative, but very few ever make it. It's a highly political process. If you don't make partner, just quit and start your own consulting firm. The CEO of my old firm did that and retired before 40 with probably $20 million in the bank.

 

[aggernodi]

Given we are talking strictly money... In the overall scheme of things, physicians make the most money of any profession in the United States based on the US Bureau of Labor Statistics:

http://www.bizjournals.com/specials/2006/0313/401_jobs.html

I have plenty of friends in consulting and they work their butt off (80-100 hour weeks) in order to make 6 figures. I'm in private practice ENT, work about 40 hours a week, and make well over $250,000. Other physician specialists make even more... cardiology, GI, etc.

I can make even more money if I want to if I work more hours, but I like my free time. Besides, I'm beginning to realize I can make a very good income by just investing wisely.

But wait... doctors are on-call. Well, so are consultants depending on what area you go into and how demanding your boss is. There's also the fact that consultants can get fired. As a general rule, physicians can't really get "fired"... the rare exceptions being malpractice or being mean to patients and colleagues.

Finally, as a consultant, you will always be NOT the boss. There will always be someone above you (well, I guess you could become CEO in which case you made the right decision to go into consulting). As a private practice physician, YOU are the boss. You can hire and fire folks. Nobody really tells what you can or cannot do. Although insurance is an issue, a physician chooses which insurance carriers he wishes to participate with.

 

[Sir William Osler]

first of all to make anything close to being a specialist doc you'll need to be at one of the tip tier consulting firms. They dont hand out these jobs as every MBA, some smart PhDs, and JDS want these jobs. And you wont start off making more than a primary care doctor. Now, if you're excellent you'll rise through the ranks and make much more than a doc or you'll leave the firm for a Fortune500 or some other "real" job. But there's a chance you wont be good, burn out, and return to residency.

The big question is whether you like corporate work (making money for a company) or physician work (caring for a patient). Its a long life so you better get this one right. In the process of studying for cases for the interview, you'll probably realize which of these you prefer.

Either way these are good options. Do some networking around school and talk to ex-consultants to see what its like. If you think you want to do it, start preparing for the interviews and research the companies.

good luck and have fun.

SWO

 

[gonogo]

Taurus, aggernodi and SWO: all your comments were VERY helpful. I guess now I have to think very well what will be my best choice. Many thanks!

 

[IceMan0824]

http://www.bizjournals.com/specials/2006/0313/401_jobs.html

Just adding my two cents. But first, a comment on the link above from aggernodi. This link list the average salary of occupations. This does not mean that physicians make the most money of any profession, simply the average pay of physicians is the greatest. Everyone knows this already...with the time you spend in school as an investment in yourself, you come out highly paid vs. most other careers. I once heard "In Medicine, the floor is high, but the ceiling is not much higher, meanwhile in business, the floor is low, but the ceiling is non-existent." You quoted some salaries, but if I quote this to you http://www.investor.reuters.wallst.com/stocks/OfficerProfile.asp?rpc=66&symbol=IHR&ID=153513, this is the salary + compensation of Interstate Hotels and Resort's CEO. If I tell you he is on the low end of the total compensation, will you believe it.
Moral of the lesson: Yes, business salaries average out a lot less than physicians, but if you can stand out wayyyyyy above the crowd, you'll make significantly more than any physician. I didn't even get into opportunity cost (extra salary phsyicians lose for the time they spend training: 2 yr MBA vs. 4 yr MD, 2 yr IM, 3 yr card fellow, and maybe 1-2 yr interventional for that lucrative card salary)(if you get an additional EMBA, it's usually paid by the business and most are night classes, so I exclude it here)


I think money should always be a consideration. Don't let anyone tell you otherwise. Do note that money is not the solution to all problems, but it does solve a lot.
Your decision should be based on what you really want to do later on in life, and how you want to live that life. Like I mentioned, just because there is money in business does not mean you will be making it, (There is a reason the average is low), meanwhile as a physician, you will be almost guaranteed a base salary.(watch out for government intervention though)

Lifestyles are also different, and equally rewarding and stressful in their own ways. A little research into the different aspects of each allow you to see which direction you are most likely to lean.

Most people, like Sir WO, and Taurus have given some good suggestions, but overall, I will suggest taking a closer(and perhaps personal) look into each side, and then decide which will maximize your overall happiness now, later, and in there far future.

Good Luck.

 

[aggernodi]

Sorry... my mistake IceMan. The salaries quoted from the US Bureau of Labor Statistics are indeed averages... But I do think it signficant that the physicians are ranked number one. My response would be that there are stellar salaries in every job profession if one looks at the top echelon. Indeed, I'm sure if I look hard enough, I can find a cook at a 5 star NYC restaurant, teacher/professor at an Ivy League university, or even a nanny who makes way more money than the average physician let alone any CEO of a major international corporation. But chances are, most people who go into consulting won't make it to the top.

But it sounds like we all agree that in the end, what is most important is what you most enjoy doing... and the money will (hopefully) come. Or else, you may be making money but feeling miserable, unhappy, and frustrated.

 

[Taurus]

If I were you, I would tough it out for another 4-5 years and become an attending. It's more guaranteed than becoming partner. I would go into consulting only if I thought I had what I takes to become partner. Otherwise, it's not worth it. The hours are bad, pay is not that high, you'll always have to kiss ass, and no job security. Did I forget to mention that it may take you 10 years before you ever reach partner level? Also, life is not exactly stress-free as a partner. You better hit a certain number of sales or you'll be looking for another job.

 

[gonogo]

You made a very good point IceMan. And I do agree that going into the corporate world is far more risky than practicing clinical medicine.

OK, so I've been thinking a lot about what I'll do and I've tried to assess my situation. Here are some non-conclusive thoughts on where I stand right now:

-I do enjoy medicine, so I would definitely enjoy working as a doctor.

-I do want to make money, and in fact I would love to make 500 k / year. For those of us who plan or wish to live in a big city, look at real state and figure out how much you actually need to make in order to afford a nice place. I don't think with a salary of less than half a million you would be able to buy a nice property in NY or SF.

-I do agree that practicing medicine will assure me a salary of 150 - 200K. I have to say that I don't particularly enjoy surgery, which means I would probably be doing something which won't involve any kind of procedures.

-As I said, I still have the question of whether using my skills and knowledge in something else will give me in the end more money. And again, I have to admit than when it really appeals to me be able to be one of those people who are making 1 million a year.

 

[aggernodi]

-I do agree that practicing medicine will assure me a salary of 150 - 200K. I have to say that I don't particularly enjoy surgery, which means I would probably be doing something which won't involve any kind of procedures.

-As I said, I still have the question of whether using my skills and knowledge in something else will give me in the end more money. And again, I have to admit than when it really appeals to me be able to be one of those people who are making 1 million a year.

I hate to say it, but if your goal is to make $1,000,000 a year but not go into a procedurally intensive medical field, than your best bet is to go into business.

However, making $1,000,000 in ANY field (even in business) is going to take a TON of work, mucho hours, much personal sacrifice, and lots of luck. If it was that easy to make that kind of dough, than everybody with a college degree would be millionaires.

Best of luck.

 

[dphoenix]

My 2 cents. . .

I am also an MD/PhD, embarking on a similar decision and this is what I've come up with:

Consulting/Banking - 10% chance of making > doctor, 80% same, 10% lower

Medicine - 100% of making 300-700k if match into ROAD, plastics, neurosurg, ortho

So money wise its kindof a crapshoot, every scenario I figure that either path I have about the same earnings, with business having a larger variance.

But there is one thing that tips the scale towards medicine - TIME!

There is NO other profession besides radiology and dermatology that allows you to make bank and have 10-12 wks off a year. Banking, consulting, CEO, whatever requires you to sacrifice your life to the business - and that doesn't guarantee money in the bank.

BUT. . .when it comes down to it you need to choose what you like - i try to tell myself to imagine I just won the lottery and which would I choose. Because I truly believe if you don't like what you are doing, you'll never succeed (financially and emotionally).

 

[Taurus]

Consulting/Banking - 10% chance of making > doctor, 80% same, 10% lower

80% is highly optimistic in my opinion. If you're smart enough to do MD/PhD, you'll probably make more than $100k easy. More than $150k is really tough. You'll have to go pretty far in consulting before you make more than that. More than $150k is usually senior managers who are one level away from partner (it depends on the city too).

 

[wallstdoc]

If you want to make lots of money, why did you go to medical school to begin with? Seriously, doctors make chump change when compared to a lot of business professions. I am talking from experience, if you want to make money, be in business, not medicine. The amount of money you can make in business is disgusting when compared to medicine (dont get me wrong, I am here to make money too). With the ever increasing regulation on medicine and the time and money needed to get the degree (although you have already done this), there are TONS of easier ways to make money. If money is what you are worried about, go be a consultant. But, do you really know what you are in for? Do you know any consultants? The coporate world is VERY (I wish I could make this font bigger) different than medicine/academia. But hey, you can always go back, that is what is great about being a doctor. Once you have that degree, you are going to be in demand no matter what.

 

[peacefuljourney]

Hi All,

I think most of the key points have come out here. I was director level at one of the big 5 (oops 4) and the money is good and I've taken on meds (at great opportunity cost...) because:

1. job stability is never there in consulting
2. you have at least 2 bosses at any given time - client and whoever inside the firm
3. you are on call 24/7
4. always on the road (or plane in my case)
5. deal with difficult and shi$#* problems that the firm wants to drop on an outsider
6. you need to 'sell' and bring in business constantly
7. ethics? what ethics.

Just to note that partnerships can be bought - they aren't always earned from the bottom up. Depending on the firm and division the price varies. But you can buy your way in esp. with a good client list.

I would suggest using your degrees as leverage. In other words, with MD/PhD or MD or whatever folks have here - banks/investors will give you what you want with a bit down and a solid plan. The MD salary is your starting point - your downpayment for your investment plan (markets, real estate, businesses etc.). The trick is to keep enough free time while practising to build up your portfolio of assets and run them well.

S-

 

[Techmonkey]

Heh the funny thing is I'm currently in London. It's pretty much the other way around here. In a socialized healthcare system, specialist salaries are much lower (80k pounds at consultant level) vs banking salaries (which are on par or higher than those in the US). The country is also starting to close some hospitals and shunt more work to GPs (FPs for u Yanks) and hence there are even fewer specialist posts here. So much for vaunted job security.

The money question should actually be a quality-of-life question in my mind. If you want to work in a major city then banking will be a better choice (assuming you're suited for the role) from a monetary and competitiveness perspective. If you're not a city person then banking is pretty much out and medicine is probably top dog.

 

[dr kevin40]

Please also consider lifestyle...

in Medicine, residency hours suck but definitely improve in late R2-R3.

in consultng, there is usually a lot of traveling in the big firms and ESPECIALLY IF U WANT TO GET THE PROJECTS THAT INTEREST YOU (during recruitment most firms say travel 40-60% of the time in the first year associates)

Of course this is VERY firm dependent and specialty depdent. Large firms usually mean traveling more. Small regional firms muchless, but also much less compensation potential. Some exceptions I'd say are if you want to specialize in financial consulting and be in New york/boston offices of the big 3, pharmaceuticals in NY/NJ area, Media consulting in NY or LA... that's as much as I can remember.

Lastly. SALES as most others have alluded is what its all about.

But the awesome hting about consulting is after 2-3 years, you can def try to leverage your experience at the firms into corporate positiions instead of staying on the partner track. And this route doesn't make you a LOSER (like say in law) but rather a winnner. possibly greater compensation, invested in ONE actual company rather than just the process of thking through business process, and LESS TRAVELING.

(for me traveling seeemd exciting at first, with the nice hotels, free miles, free meals, etc, but soon after all hotel rooms are the same to me and it lost its luster. airports suck when it comes to nonvacation purposes)

Some awesome aspects of consulting is that in a BIG firm, you get to work with C and V levels DIRECTLY, and you get to really learn the workings of AS MANY INDUSTRIES AS YOU WANT before you specialize lateraly or vertically(or stay as a generalist). this i thnk is so awesome unlike medicine where you are often forced to pick something based on limited clinical exp

And unlike what most have said, consulting is usually recession proof *unlike say banking or corp law.

 

[dr kevin40]

Now lets talk about medicine and its problems.

Long training for **** pay...solution? go not sure.

government policies on decreasing compensatoins. solution > notsure

litiginous society. soln? be nice to them.