How to balance finances and interests when choosing specialty?

[Unshuretain]

Yeah it’s the whole “if all goes well” part that typically throws a wrench in that 7 figure payday. Who knows, maybe she’ll be one of the lucky ones.

Sure, and don't you see how this applies to those going into medicine and science too? If you're not convinced, check out a similar forum to this one called Wallstreetoasis. It didn't take much browsing over there to disillusion me.

The ucla pics are somewhat comical seeing as ucla has some of the highest physician pay in the world. I’m guessing those are all residents in the pics. As for the faculty docs, a quick look at California public salary databases show plenty of docs making 7 figures there. And even more of them in the very high 6s.

I think that further proves what some of us have been arguing. Even at one of the best-paying institutions in the world, there are still physicians considering UberEats as a side-hustle. Don't you think that's wrong? I don't agree with the "but those are all residents" argument because that is outright hazing mentality. Nobody graduating with that much debt should have to work those hours and also consider UberEats. I don't know what's comical here.

Also, I don't know where you're getting your numbers. Are you looking up neurosurgeons? I just looked up an endocrinologist in California's public salary database. They're making $86k regular pay and $223k gross. Another: $140k regular and $290k gross. The other salaries seem to be in that range. That doesn't seem much considering the 6 additional years of clinical training after any degrees you're coming in with. And as you said, this is one of the best-paying institutions.


I'm still confused why many are so resistant to asking for fairer compensation, given the objectively greater societal benefit physicians bring. I can't think of another profession where it's so, overwhelmingly positive.

I used to think we ended up where we are today because institutions—academic or otherwise—take advantage of a self-selecting group of individuals passionate about "fighting the good fight." We were the ones most likely to stay after classes to help out a high school friend. But at this point, I think the reason is this holier-than-thou mentality from colleagues. After all, you seem to think it's "comical" someone can't support themselves and their family? I hope this isn't what you actually think, because if so, I really am not excited to be working with/for people with this mindset.

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[Unshuretain]

I think you might be overestimating the difficulty in getting accepted into a medical school. Average acceptance rate for medical school is around 41%. Top MBA program rate looks to average out at around 20-25% by my rough estimation. Lowest I saw was around 7% with the highest around 35% or so.

This topic comes up irritatingly often and its always the same. "Look at all the tech/business/banking/whatever people making great money at younger ages than physicians!!!!". And it always overlooks the same things over and over again.

- Graduating from a T20 MBA school doesn't guarantee you a great income.
- The skills needed to succeed at business/tech/whatever don't necessarily translate from those good at science. This is honestly the key point in all of those. To become a doctor you need to be really good at studying with just enough of a personality to not creep people out on interview day. That would not make you successful in much of the business world.
- Barring a massive shift in healthcare, our jobs are among the most stable in the country. If you look at most stable jobs, its like 90% healthcare jobs. This isn't just about job availability either which from my reading is also good in business, but people staying in their jobs long term.
- Most physicians make a good bit more than is widely appreciated. For example, most sources I have access to say that 90% of neurosurgeons earn less than 950k. I do not know a single neurosurgeon making less than 1 mil. Most are closer to 1.3/4. Average for FM is around 240k at the moment. Most of the FPs I know are almost doubling that.

These are all very interesting thoughts, and I think you framed them quite well. Vox's analogy to stable S&P500 index fund vs. a risky investment is good too. I would also like to add that, unlike a risky investment, what money you do earn stays with you. The finance bro making $5 million who gets fired because the economy did a 180 is still $5 million richer (or maybe a bit less) than the physician who's still toiling in residency. $5 million might be more than what a physician will make throughout their entire career depending on their specialty.

I also think you might be somewhat overestimating what it takes to succeed in business. For sake of not disclosing too much information, I did actually interview at a few firms right out of undergrad—just to prove to myself I could do it. I got prep material from an undergrad friend. I received offers for more than half of those firms. I guess that doesn’t predict my long term success, but I do think about life-that-could-have-been a lot every night in bed. On the other hand, I put everything into my med school application, and I barely eked out. Again, n=1 in this case, so take of it what you will.

Just some thoughts.

Your post does inspire some hope in me. I'm maintaining a healthy level of skepticism though, as you probably are with my observations. Don't get me wrong, I want nothing but for what you're saying to be 100% true. We both do. I just have way too many trust issues at this point, seeing all my undergrad colleagues live actual lives—car, house, family, vacations, etc.—while I "do it for the patients."

 

[VA Hopeful Dr]

These are all very interesting thoughts, and I think you framed them quite well. Vox's analogy to stable S&P500 index fund vs. a risky investment is good too. I would also like to add that, unlike a risky investment, what money you do earn stays with you. The finance bro making $5 million who gets fired because the economy did a 180 is still $5 million richer (or maybe a bit less) than the physician who's still toiling in residency. $5 million might be more than what a physician will make throughout their entire career depending on their specialty.

I also think you might be somewhat overestimating what it takes to succeed in business. For sake of not disclosing too much information, I did actually interview at a few firms right out of undergrad—just to prove to myself I could do it. I got prep material from an undergrad friend. I received offers for more than half of those firms. I guess that doesn’t predict my long term success, but I do think about life-that-could-have-been a lot every night in bed. On the other hand, I put everything into my med school application, and I barely eked out. Again, n=1 in this case, so take of it what you will.

Just some thoughts.

Your post does inspire some hope in me. I'm maintaining a healthy level of skepticism though, as you probably are with my observations. Don't get me wrong, I want nothing but for what you're saying to be 100% true. We both do. I just have way too many trust issues at this point, seeing all my undergrad colleagues live actual lives—car, house, family, vacations, etc.—while I "do it for the patients."

Sure, you can out earn medicine doing lots of things. But many people don't. And even the ones that do, its not the same stability. I have a cousin who did very well doing some kind of finance in NY for quite a few years... then spent 2 years unemployed around 2008 for some reason.

Residency and student loans are a whole other can of worms.

 

[VA Hopeful Dr]

Sure, and don't you see how this applies to those going into medicine and science too? If you're not convinced, check out a similar forum to this one called Wallstreetoasis. It didn't take much browsing over there to disillusion me.


I think that further proves what some of us have been arguing. Even at one of the best-paying institutions in the world, there are still physicians considering UberEats as a side-hustle. Don't you think that's wrong? I don't agree with the "but those are all residents" argument because that is outright hazing mentality. Nobody graduating with that much debt should have to work those hours and also consider UberEats. I don't know what's comical here.

Also, I don't know where you're getting your numbers. Are you looking up neurosurgeons? I just looked up an endocrinologist in California's public salary database. They're making $86k regular pay and $223k gross. Another: $140k regular and $290k gross. The other salaries seem to be in that range. That doesn't seem much considering the 6 additional years of clinical training after any degrees you're coming in with. And as you said, this is one of the best-paying institutions.


I'm still confused why many are so resistant to asking for fairer compensation, given the objectively greater societal benefit physicians bring. I can't think of another profession where it's so, overwhelmingly positive.

I used to think we ended up where we are today because institutions—academic or otherwise—take advantage of a self-selecting group of individuals passionate about "fighting the good fight." We were the ones most likely to stay after classes to help out a high school friend. But at this point, I think the reason is this holier-than-thou mentality from colleagues. After all, you seem to think it's "comical" someone can't support themselves and their family? I hope this isn't what you actually think, because if so, I really am not excited to be working with/for people with this mindset.

Because on the whole we're paid exceptionally well.

Now the student loan issue is a huge issue but that's a whole other thing.

 

[Future_Bone_Docta]

I think that further proves what some of us have been arguing. Even at one of the best-paying institutions in the world, there are still physicians considering UberEats as a side-hustle. Don't you think that's wrong? I don't agree with the "but those are all residents" argument because that is outright hazing mentality. Nobody graduating with that much debt should have to work those hours and also consider UberEats. I don't know what's comical here.

The key is the debt. Most would have no problem working 80 hr/wk 55-65k per year... if you didn't have to worry about that 350k in debt turning into 525k by the end.

Also the fact that mid-levels make triple the hourly rate as residents WHILE functioning as residents

 

[deleted1065184]

The key is the debt. Most would have no problem working 80 hr/wk 55-65k per year... if you didn't have to worry about that 350k in debt turning into 525k by the end.

Also the fact that mid-levels make triple the hourly rate as residents WHILE functioning as residents

You cannot possibly believe that most people in ANY field have no problem working 80 hr/wk for $55-65k/yr, loans or not. Just because many have accepted their fate doesn't mean they have no problem with it. Residents should be making at least as much as APPs, period.

 

[Future_Bone_Docta]

You cannot possibly believe that most people in ANY field have no problem working 80 hr/wk for $55-65k/yr, loans or not. Just because many have accepted their fate doesn't mean they have no problem with it. Residents should be making at least as much as APPs, period.

Well definitely not ideal and I no one would prefer to (including myself). But its doable for a finite period of time. But yeah ideally put that cap at 60 hr/wk and I think everyone would be happier.

 

[bubblesdo]

Survey Says: The Time to Evaluate Your Market-Based Physician Compensation Plan Designs Is Now

Written by Anthony Domanico and Ben Minnis With the COVID-19 pandemic impacting compensation and productivity levels in 2020, significant changes to wRVU values in the 2021 Medicare physician fee schedule, and the continued industry move from volume to value-based reimbursement and compensation...

vmghealth.com

If you're on a production based comp model, things look pretty interesting with new CMS changes and visits returning to normal.