How much does a FM doctor make in Midwest

[deleted804295]

Hello everyone,

I'd like to ideally settle down in Wisconsin. My most likely choice of specialty will be FM. With that in mind, how much will I make as a first year attending? (Trying to calculate when I'd pay off loans)

Also, does anyone have a good pay off loan guide? I've read some people say that one should not pay any loans off in residency etc.

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[deleted804295]

Um. I posted this on the wrong forum. Could a mod move this to medical student (MD) forum?

 

[gyngyn]

Here you go.

 

[deleted804295]

Here you go.

Thanks gyngyn!

 

[Dr. Doctor MD]

Hello everyone,

I'd like to ideally settle down in Wisconsin. My most likely choice of specialty will be FM. With that in mind, how much will I make as a first year attending? (Trying to calculate when I'd pay off loans)

Also, does anyone have a good pay off loan guide? I've read some people say that one should not pay any loans off in residency etc.

Probably a pretty decent salary. FM averages about ~240k nationally, and both the midwest in general and wisconsin are known for higher salaries. Milwaukee is the highest compensated major metro areas for physicians in general (Doximity 2019 Physician Compensation Report)

I wouldn't imagine you having any trouble getting ~300k per year in most places in Wisconsin and if you really wanted to move to rural Wisconsin, you could be looking at compensation as high as ~350-400k per year.

 

[bananafish94]

You’ll make good money but it will depend on many factors, such as location, (are you living in Milwaukee or out in the sticks?) academia vs. private practice, scope of practice, etc. it’s hard to give a conclusive loan repayment guide because it’s such a personalized situation. How much debt are you going to have? Will you be married or single in resident? Do you want to do a fellowship? Are you interested in PSLF? I will say that wherever you read that you shouldn’t pay loans in residency...it’s probably wrong. For example, I’m going to make 12 “qualifying payments” as a PGY1 next year for $0 each because of how the repayment plans are structured. Deferring payments doesn’t let you reap those benefits and the interest will continue to accrue.

 

[efle]

Per MGMA 2018 (Private practice ambulatory FM - Midwest region):

25th percentile -190k
50th/Medain - 220k
75th percentile - 259k

 

[deleted804295]

Per MGMA 2018 (Private practice ambulatory FM - Midwest region):

25th percentile -190k
50th/Medain - 220k
75th percentile - 259k

Wow thanks! That's a lot of money.

 

[macbookproretina]

Wow thanks! That's a lot of money.

It's not as much as you think it is after taxes, loans, mortage, kids, bills

 

[Modstopizdy]

Wow thanks! That's a lot of money.

Yeah, it's super impressive, over half of what a CRNA makes! Pretty lucky considering we only have the brain of a doctor but not the heart of a nurse while the midlevels have both.

 

[efle]

It's the 2nd lowest of anything after Peds Hospitalist but hey, it's all relative

 

[Postictal Raiden]

It’s not about how much you make it’s about how much you spend.

My FM colleagues in SoCal are getting very good offers. 300k for M-F 8-5 plus covering one weekend of UC a month. 250k if you opt out of UC weekend work.

However. 250k or 300k in LA doesn’t go too far. Average house price is like 1M. Let’s not forget about the 10% sunshine tax as well

 

[efle]

Anyone who has never done this as an exercise -

Go to Zillow. Look at what a ~500-750k home looks like in the bay, LA, NYC, etc.

Then look at some medium sized midwestern cities of your choosing and see what a 500-750k home mansion on a lake looks like out there.

Having lived in both kinds of places, it's crazy to me that so many prefer to stay on the coasts.

 

[macbookproretina]

Anyone who has never done this as an exercise -

Go to Zillow. Look at what a ~500-750k home looks like in the bay, LA, NYC, etc.

Then look at some medium sized midwestern cities of your choosing and see what a 500-750k home mansion on a lake looks like out there.

Having lived in both kinds of places, it's crazy to me that so many prefer to stay on the coasts.

Maybe because having a house on a lake isn't everything? And that people might be willing to spend more money to get a same quality house but in an area with better weather, more things going on, etc

 

[bananafish94]

Anyone who has never done this as an exercise -

Go to Zillow. Look at what a ~500-750k home looks like in the bay, LA, NYC, etc.

Then look at some medium sized midwestern cities of your choosing and see what a 500-750k home mansion on a lake looks like out there.

Having lived in both kinds of places, it's crazy to me that so many prefer to stay on the coasts.

Shhhhh...nothing to see here, folks. It’s a cold wasteland.

 

[Modstopizdy]

Maybe because having a house on a lake isn't everything? And that people might be willing to spend more money to get a same quality house but in an area with better weather, more things going on, etc

Yeah the midwestern house on a lake is only good if you're married, have 3 kids needing "good schools" and are resigned to aging into your dad-bod (god I hate that term). Otherwise it's a pretty lame way to live, there is only so many times a day you can pause and reflect on how big your crib is before the effect wears off and you start scratching your head about what else to do. Not saying working for half the money and twice the taxes in Socal is any better, but the midwestern mansion just isn't the optimal way to swing it.

 

[scoopdaboop]

However. 250k or 300k in LA doesn’t go too far. Average house price is like 1M. Let’s not forget about the 10% sunshine tax as well

I've seen Kaiser offering things like 200k home assistance though so that helps.

 

[efle]

Maybe because having a house on a lake isn't everything? And that people might be willing to spend more money to get a same quality house but in an area with better weather, more things going on, etc

Yeah the midwestern house on a lake is only good if you're married, have 3 kids needing "good schools" and are resigned to aging into your dad-bod (god I hate that term). Otherwise it's a pretty lame way to live, there is only so many times a day you can pause and reflect on how big your crib is before the effect wears off and you start scratching your head about what else to do. Not saying working for half the money and twice the taxes in Socal is any better, but the midwestern mansion just isn't the optimal way to swing it.

I'm sheltering in place in an expensive part of California right now, in a rent controlled studio apartment with a murphy bed that costs $30,000/year. In the Midwestern city I used to live in, I rented a similar size studio for several months that was $5,000/year. And I'm not talking about being out in the sticks - a real city with plenty of restaurants, movie theaters, recreation etc. A college town type area too, plenty of educated and like minded people around.

As nice as the weather in SoCal is, financial independence a decade sooner at the same QoL is much nicer. When I visit the bay and SoCal there's really not much to do that can't be done in a midwest city.

 

[Mad Jack]

I've seen Kaiser offering things like 200k home assistance though so that helps.

Knew a couple that got that plus a sign on bonus that was bigger than their salary (so they had 400k for a house and 600k in cash up front) in exchange for service in a less desirable California city. Starting with a million dollars though, not bad.

 

[Postictal Raiden]

Knew a couple that got that plus a sign on bonus that was bigger than their salary (so they had 400k for a house and 600k in cash up front) in exchange for service in a less desirable California city. Starting with a million dollars though, not bad.

Not discrediting you or anything, buddy, but I find this extremely hard to believe. The Kaiser “golden handcuffs “is not new. But 600k sign on bonus doesn’t even exist for psych in North Dakota, let alone CA.

I have numerous friends in CA, and even in remote and less desirable areas, the perks aren’t that great.

 

[Postictal Raiden]

With that said, CA does offer 300k of tax free loan repayment assistance paid over 5 year period if your patient panel is at least 30% Medi-cal (CA Medicaid program).

 

[Modstopizdy]

I'm sheltering in place in an expensive part of California right now, in a rent controlled studio apartment with a murphy bed that costs $30,000/year. In the Midwestern city I used to live in, I rented a similar size studio for several months that was $5,000/year. And I'm not talking about being out in the sticks - a real city with plenty of restaurants, movie theaters, recreation etc. A college town type area too, plenty of educated and like minded people around.

As nice as the weather in SoCal is, financial independence a decade sooner at the same QoL is much nicer. When I visit the bay and SoCal there's really not much to do that can't be done in a midwest city.

I agree, I would never want to work in a place like Socal or NYC where the salaries are low and cost of living and taxes are high. I was just saying that the midwestern McMansion isn't ideal either unless you're ready to settle into the middle-aged life. From my perspective the ideal set up as a young attending is to work where you can make the most money and then take trips to your favorite spots when you're off. Now personally I'll be doing 7 on 7 off type of work which obviously isn't gonna be everyone's cup of tea but the general idea still applies I think. Bank that money, reduce the fixed expenses as much as possible-so no McMansion-and then just have the free cashflow to play with.

 

[Dochopeful13]

Yeah, it's super impressive, over half of what a CRNA makes! Pretty lucky considering we only have the brain of a doctor but not the heart of a nurse while the midlevels have both.

Lol. I have a buddy who is a CRNA and he makes 230k~ in a large midwestern city. Primary care salaries and crna salaries are pretty comparable.

 

[Mad Jack]

Not discrediting you or anything, buddy, but I find this extremely hard to believe. The Kaiser “golden handcuffs “is not new. But 600k sign on bonus doesn’t even exist for psych in North Dakota, let alone CA.

I have numerous friends in CA, and even in remote and less desirable areas, the perks aren’t that great.

It was 300k a piece for FM in a fairly undesirable city with a very lengthy contract (I believe it was something like 5 years for the housing bonus and another five years for the sign on bonus) a few years back. Base salary wasn't great though. Because it was a couple that were graduating together, they both got the bonuses individually and it made for quite the package for the two of them to work with. If you broke it down year by year with the obligations it came to like 265k a year, but you were getting a lot of the money up front

 

[Perrotfish]

Yeah the midwestern house on a lake is only good if you're married, have 3 kids needing "good schools" and are resigned to aging into your dad-bod (god I hate that term). Otherwise it's a pretty lame way to live, there is only so many times a day you can pause and reflect on how big your crib is before the effect wears off and you start scratching your head about what else to do. Not saying working for half the money and twice the taxes in Socal is any better, but the midwestern mansion just isn't the optimal way to swing it.

I'm not sure how much time you have spent in midsized cities, but usually they have pretty much everything you would want to do with your spare time. If you want something that's specific to a region (surfing, skiing, etc) then there is probably a midsized city that matches your needs and it has all of the dining and nightlife that you're likely to use. There is definitely more to do when you move out small town America to a bigger city, but there is a rapidly diminishing return with increasing population density.

Also its worth noting that more underserved areas don't just have cheaper housing and better pay, they also work you less and treat you better overall. Sunny SoCal isn't just the land of low salaries and tiny apartments, its also the land of night and weekend clinics. In contrast most of the places I interviewed at in more underserved areas were offering 4 day work weeks. There is only so much fun you can have in San Diego if you are churning through more than 150 patients per week.

 

[V5RED]

Yeah, it's super impressive, over half of what a CRNA makes! Pretty lucky considering we only have the brain of a doctor but not the heart of a nurse while the midlevels have both.

"The Bureau of Labor Statistics (BLS) reports the average income of a nurse anesthetist to be $169,450 per year"

But sure, let's make things up to make people think the sky is falling for primary care(which people were saying back when I joined this site and somehow it still hasn't happened)

How to Become a Certified Registered Nurse Anesthetist (CRNA)

If you're a Registered Nurse (RN) looking for more autonomy working with patients in an operating room, intensive care unit, or surgical facility, then becoming a Certified Registered Nurse Anesthetist (CRNA) might be the perfect job for you.

nurse.org

 

[efle]

"The Bureau of Labor Statistics (BLS) reports the average income of a nurse anesthetist to be $169,450 per year"

But sure, let's make things up to make people think the sky is falling for primary care(which people were saying back when I joined this site and somehow it still hasn't happened)

How to Become a Certified Registered Nurse Anesthetist (CRNA)

If you're a Registered Nurse (RN) looking for more autonomy working with patients in an operating room, intensive care unit, or surgical facility, then becoming a Certified Registered Nurse Anesthetist (CRNA) might be the perfect job for you.

nurse.org

The BLS also thinks Anesthesiologists make 267k average. MGMA average is >150,000 higher than that.

Anesthesiologists

www.bls.gov

A CRNA in the midwest can absolutely give a primary care doc a run for their money, if you account for total hours worked.

 

[deleted804295]

Anyone who has never done this as an exercise -

Go to Zillow. Look at what a ~500-750k home looks like in the bay, LA, NYC, etc.

Then look at some medium sized midwestern cities of your choosing and see what a 500-750k home mansion on a lake looks like out there.

Having lived in both kinds of places, it's crazy to me that so many prefer to stay on the coasts.

I love the midwest. Going to live here forever. I hate crowded cities

 

[deleted804295]

Yeah the midwestern house on a lake is only good if you're married, have 3 kids needing "good schools" and are resigned to aging into your dad-bod (god I hate that term). Otherwise it's a pretty lame way to live, there is only so many times a day you can pause and reflect on how big your crib is before the effect wears off and you start scratching your head about what else to do. Not saying working for half the money and twice the taxes in Socal is any better, but the midwestern mansion just isn't the optimal way to swing it.

And you're saying consumerist life in san frans is any better?

 

[deleted804295]

I agree, I would never want to work in a place like Socal or NYC where the salaries are low and cost of living and taxes are high. I was just saying that the midwestern McMansion isn't ideal either unless you're ready to settle into the middle-aged life. From my perspective the ideal set up as a young attending is to work where you can make the most money and then take trips to your favorite spots when you're off. Now personally I'll be doing 7 on 7 off type of work which obviously isn't gonna be everyone's cup of tea but the general idea still applies I think. Bank that money, reduce the fixed expenses as much as possible-so no McMansion-and then just have the free cashflow to play with.

Middle aged lifestyle is having fresh nature and mountains to hike in, lakes to fish, and plenty of wood to make bonfires? I'll be middle aged forever then.

Your travel lifestyle can be done in any part of the country and frankly it's more cost effective doing it in the midwest due to low living expenses.

 

[Mass Effect]

Yeah the midwestern house on a lake is only good if you're married, have 3 kids needing "good schools" and are resigned to aging into your dad-bod (god I hate that term). Otherwise it's a pretty lame way to live, there is only so many times a day you can pause and reflect on how big your crib is before the effect wears off and you start scratching your head about what else to do. Not saying working for half the money and twice the taxes in Socal is any better, but the midwestern mansion just isn't the optimal way to swing it.

For many people who've outgrown partying at the local bars, the midwest/rural west offers a pretty decent lifestyle. There's plenty to do if you think outside of bar-hopping.

 

[V5RED]

The BLS also thinks Anesthesiologists make 267k average. MGMA average is >150,000 higher than that.

Anesthesiologists

www.bls.gov

A CRNA in the midwest can absolutely give a primary care doc a run for their money, if you account for total hours worked.

Here is the Medscape number. 188k in 2018 down from 192k in 2017.

Compared to most nurses, they make a shed load. They are also not paid massively less than PCPs, but the guy claiming a PCP on average makes half was clearly making things up and when you compare their average to any medical specialty, they are making less than every one.

Medscape: Medscape Access

 

[zero0]

this may help

2019 Midwest salary

 

[deleted804295]

I keep getting high numbers. I'm wondering what First year attendings make not median salaries of all attendings.

 

[PorkChopsOG]

For many people who've outgrown partying at the local bars, the midwest/rural west offers a pretty decent lifestyle. There's plenty to do if you think outside of bar-hopping.

But like, OMG, how am I supposed to get [insert random ethnic food] at 3AM if I'm not in LA????

 

[hallowmann]

It’s not about how much you make it’s about how much you spend.

My FM colleagues in SoCal are getting very good offers. 300k for M-F 8-5 plus covering one weekend of UC a month. 250k if you opt out of UC weekend work.

However. 250k or 300k in LA doesn’t go too far. Average house price is like 1M. Let’s not forget about the 10% sunshine tax as well

True, but $300k and a $750k home about an hour from the beach isn't bad if you don't mind being a bit inland. Sure, you're not getting the 5-6k sq ft mansion in the midwest, but its probably enough for most families and not having to deal with winter/snow again is tempting every year.

Honestly I find a lot of these comparisons pointless. Some people have reasons to be on the coasts, others don't, but realistically as a physician you can make things work pretty well almost anywhere if you are a bit flexible.

I keep getting high numbers. I'm wondering what First year attendings make not median salaries of all attendings.

<$180k in academia, ~$240k elsewhere, but depending on the job (inpt, UC coverage, OB, call, etc.) you can get closer to $300k.

 

[InternistDO]

I swear, if you only looked on SDN you'd think that all doctors lived in the suburban and rural midwest and New York and California were desolate medical wastelands where doctors feared to tread.

Others have answered about the pay, but for paying off student loans you should check out the White Coat Investor--he has a book and a website/forum if you google it. Lots of articles about the different federal loan repayment plans vs private refinancing and that kind of thing.

 

[Chibucks15]

I swear, if you only looked on SDN you'd think that all doctors lived in the suburban and rural midwest and New York and California were desolate medical wastelands where doctors feared to tread.

Others have answered about the pay, but for paying off student loans you should check out the White Coat Investor--he has a book and a website/forum if you google it. Lots of articles about the different federal loan repayment plans vs private refinancing and that kind of thing.

That is the exact opposite of what I see on SDN haha everyone wants to get to the coasts on here and anywhere in the midwest not named Chicago is like poison to match lists and such according to the people on here.

 

[InternistDO]

That is the exact opposite of what I see on SDN haha everyone wants to get to the coasts on here and anywhere in the midwest not named Chicago is like poison to match lists and such according to the people on here.

Yeah I guess that's true. I'd say any thread about match lists/residency is tremendously pro-coasts, and any thread about salary will be the complete opposite.

 

[RangerBob]

Anyone who has never done this as an exercise -

Go to Zillow. Look at what a ~500-750k home looks like in the bay, LA, NYC, etc.

Then look at some medium sized midwestern cities of your choosing and see what a 500-750k home mansion on a lake looks like out there.

Having lived in both kinds of places, it's crazy to me that so many prefer to stay on the coasts.

While I actually really liked the Midwest and would’ve been happy to stay, you really can’t find better weather than parts of CA. I see the ocean fairly on my commute. Granted, I’d rather see pine trees and mountains on my commute...

Financially yes, it doesn’t make sense to live on the coasts. But as a physician we’re in a privileged enough place that we can live anywhere in the US. My family happens to live in CA, and the weather is great.

I did try and talk them all into moving to the Midwest (Great Lakes area) but I wasn’t successful. I could’ve bought all of them a home... our 2bd/1ba home in residency was $100k.

 

[Mass Effect]

True, but $300k and a $750k home about an hour from the beach isn't bad if you don't mind being a bit inland. Sure, you're not getting the 5-6k sq ft mansion in the midwest, but its probably enough for most families and not having to deal with winter/snow again is tempting every year

There are places not on the coast where you don't have to deal with winter/snow again and they're pretty cheap, thinking the south specifically (in the middle part of the country). I wouldn't want to live there, but people can.

 

[Mass Effect]

While I actually really liked the Midwest and would’ve been happy to stay, you really can’t find better weather than parts of CA. I see the ocean fairly on my commute. Granted, I’d rather see pine trees and mountains on my commute...

Financially yes, it doesn’t make sense to live on the coasts. But as a physician we’re in a privileged enough place that we can live anywhere in the US. My family happens to live in CA, and the weather is great.

I did try and talk them all into moving to the Midwest (Great Lakes area) but I wasn’t successful. I could’ve bought all of them a home... our 2bd/1ba home in residency was $100k.

The thing is it doesn't have to be either/or. You can get the advantages of CA in other states that aren't nearly as expensive but still on the coasts. Parts of GA are beautiful and you have beaches and mountains within the state. Same with SC. If you're willing to put up with the seasons (and mild winters relative to midwest), NC and VA are amazing.

That also goes for those favoring the midwest due to prices and fresh nature. There are places on the coasts that give you plenty of nature and as rural or urban a lifestyle as you like (not like NYC or LA, but there's no shortage of dining and nightlife options). Some of my best summers were spent on the beaches, lakes, and mountains in some village in Maine where it was insanely cheap to live and plenty of outdoor activities. A few hours away was Portland that was very similar to some of the midwestern cities I lived in and comparable in price. I think depending on what you want, you can find a city to offer it almost anywhere in the country.

Personally as someone living the urban lifestyle right now, I can't wait to retreat to a smaller town. I haven't decided if that will be some place in the midwest (maybe Milwaukee?) or the east (maybe Maine?) or the south (maybe NC or SC?). I just can't stand the pollution, the crowds, the rush, rush, rush, the commute to...anywhere, the prices both in homes and in groceries, and the noise that's unbelievably annoying. Give me the sweet sounds of nature, hiking trails, a huge yet cozy home with a large deck to entertain, a 5-minute commute to work, and a large paycheck to boot and I'll be happy.

 

[IntheClouds4ever]

If you are in REPAYE then it’s probably best to not make any more than your required payments. You’ll get half the interest paid for and if you are >200k in debt the payments just to cover interest are near $1k/month. You’d be better off saving that money for your emergency fund and let it grow while Uncle Sam pays off half your interest otherwise you’re losing out on the free government money. Once you graduate you can take your savings and signon bonus for a large lump sum payment and then refinance if you desire.. just remember that every dollar you pay (assuming you can’t pay more than the interest it’s accruing) is worth only $0.50 since you would be foregoing free money towards interest from Uncle Sam.

also, I’m in the Bible Belt and signed a contract for $250k guaranteed for 2 years plus sign on, residency stipend, etc..assuming youdon’t have >350k in student loan debt, it’ll be easy to pay off

 

[bananafish94]

I only applied to the Midwest for residency and I'm extremely happy to do my training in a low-COL area. I have friends in places like California and New York and they're fun to visit. But some of these places like SF and NYC would require me to make literally twice as much money - and residency salaries are all basically the same. I've been a student forever and spent too much time fretting about money and how pouring everything I have into rent. It will be really nice to actually start saving money and to have the ability to travel and go to nice restaurants every once in awhile. I've lived in the Midwest my whole life and I've never felt like I'm missing anything. I've lived in college towns, suburbs, big cities, and always felt like there's lots for me to do. I think that a lot of people who have these preconceptions about the area don't honestly know anything about it or what it offers.

 

[deleted804295]

If you are in REPAYE then it’s probably best to not make any more than your required payments. You’ll get half the interest paid for and if you are >200k in debt the payments just to cover interest are near $1k/month. You’d be better off saving that money for your emergency fund and let it grow while Uncle Sam pays off half your interest otherwise you’re losing out on the free government money. Once you graduate you can take your savings and signon bonus for a large lump sum payment and then refinance if you desire.. just remember that every dollar you pay (assuming you can’t pay more than the interest it’s accruing) is worth only $0.50 since you would be foregoing free money towards interest from Uncle Sam.

also, I’m in the Bible Belt and signed a contract for $250k guaranteed for 2 years plus sign on, residency stipend, etc..assuming youdon’t have >350k in student loan debt, it’ll be easy to pay off

Could you tell my more about when to pay off loans, when it's a good idea to only pay interest etc.?

I'm matriculating this fall and the total cost of attendance from the financial aid office freaked me out a bit since I've never taken out loans before.

 

[ciestar]

That is the exact opposite of what I see on SDN haha everyone wants to get to the coasts on here and anywhere in the midwest not named Chicago is like poison to match lists and such according to the people on here.

Lol im from rural PA and id absolutely hate to have to go back to that...

 

[RangerBob]

The thing is it doesn't have to be either/or. You can get the advantages of CA in other states that aren't nearly as expensive but still on the coasts. Parts of GA are beautiful and you have beaches and mountains within the state. Same with SC. If you're willing to put up with the seasons (and mild winters relative to midwest), NC and VA are amazing.

That also goes for those favoring the midwest due to prices and fresh nature. There are places on the coasts that give you plenty of nature and as rural or urban a lifestyle as you like (not like NYC or LA, but there's no shortage of dining and nightlife options). Some of my best summers were spent on the beaches, lakes, and mountains in some village in Maine where it was insanely cheap to live and plenty of outdoor activities. A few hours away was Portland that was very similar to some of the midwestern cities I lived in and comparable in price. I think depending on what you want, you can find a city to offer it almost anywhere in the country.

Personally as someone living the urban lifestyle right now, I can't wait to retreat to a smaller town. I haven't decided if that will be some place in the midwest (maybe Milwaukee?) or the east (maybe Maine?) or the south (maybe NC or SC?). I just can't stand the pollution, the crowds, the rush, rush, rush, the commute to...anywhere, the prices both in homes and in groceries, and the noise that's unbelievably annoying. Give me the sweet sounds of nature, hiking trails, a huge yet cozy home with a large deck to entertain, a 5-minute commute to work, and a large paycheck to boot and I'll be happy.

I agree. We’re in CA because it’s where my family is. And thankfully it’s not LA/SF-we’re fairly rural. Lots of hiking, though not as good as the PNW (my favorite place to camp/hike). I couldn’t live in areas that congested.

There are lots of great places to live. Some cheap, some expensive. I could be happy almost anywhere as long as my family was with me. But if they were in LA or NYC I’d have to reconsider...

 

[efle]

I second the PNW. Most beautiful nature, no real winter in most of OR and WA, relatively very cheap to have a house on the fringes of a city like Portland.

I think a lot of the coastal love comes from lack of exposure. My friends who went to college in LA/SF/San Diego stayed there to work. My classmates who grew up and went to college all in the big New England metros, same thing, they all want to match Boston and NYC and Philly.

If they'd spent a few years somewhere like Durham, Nashville, Atlanta, Austin, St Louis, Minneapolis, etc I think a lot of them would have been a lot more flexible about it. They talk about the Midwest and South like wastelands devoid of yuppies or things for yuppies to do. Really you can find all the usual entertainment in any cities that big, and when you drive a short while away from the city centers, you'll get 5x as much house per dollar.

 

[deleted936470]

I'd rather couch surf on the west coast then have a home in st. louis

 

[efle]

I'd rather couch surf on the west coast then have a home in st. louis

How long did you spend living in st louis?