Medical School is such a scam

[nimbus]

Agreed. Plastics, urology, ENT, and a few other specialties are worth it. But that's a huge gamble. Unlike EM, they aren't opening residencies left and right, so hard to get.

Easier to have cush job as an RN in Santa Clara.

Some RN jobs can be very cush…eg school nurse or medspa work. But we also have ICU nurses who routinely take road-trips to CT scan with patients who are intubated, on 3-4 pressors and an Impella. During the pandemic, they were routinely proning 300lb patients who were intubated and had multiple lines. They are highly skilled and do difficult work. To be fair, there are a lot of MDs who wouldn’t know where to start with these types of patients.

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[miacomet]

Some RN jobs can be very cush…eg medspa work. But we also have ICU nurses who routinely take road-trips to CT scan with patients who are on 3-4 pressors and an Impella. They are highly skilled and so difficult work.

Yep, but it only requires two years of school after high school or an online degree, you can start working at 20 or so, retire easily by 40.

Medicine is also hard work, but you have to pay for school, get into a competitive specialty, then do a residency for 5-7 years where you aren't milking overtime before you actually start work. It's ridiculous.

 

[nimbus]

Yep, but it only requires two years of school after high school or an online degree, you can start working at 20 or so, retire easily by 40.

Medicine is also hard work, but you have to pay for school, get into a competitive specialty, then do a residency for 5-7 years where you aren't milking overtime before you actually start work. It's ridiculous.

I think most places nowadays require a BSN.

 

[miacomet]

I think most places nowadays require a BSN.

With today's nursing shortage, no way. They prefer it, but most will take an RN and then they can get an online degree (paid for, of course, by the hospital) while working.

But even if they do require a BSN, it's an online degree that takes less than four years.

 

[GonnaBeADoc2222]

Agreed. Plastics, urology, ENT, and a few other specialties are worth it. But that's a huge gamble. Unlike EM, they aren't opening residencies left and right, so hard to get.

Easier to have cush job as an RN in Santa Clara.

I make more than my urologist friend in academics, and my job isnt even that high paying for EM

 

[miacomet]

I think most places nowadays require a BSN.

With today's nursing shortage, no way. They prefer it, but most will take an RN and then they can get an online degree (paid for, of course, by the hospital) while working.

But even if they do require a BSN, it's an online degree that takes less than four years.

I make more than my urologist friend in academics, and my job isnt even that high paying for EM

Do you make more than your urologist friends in private practice? Are you in academics?
Do they work a ton of nights and weekends?

 

[nimbus]

With today's nursing shortage, no way. They prefer it, but most will take an RN and then they can get an online degree (paid for, of course, by the hospital) while working.

But even if they do require a BSN, it's an online degree that takes less than four years.


Do you make more than your urologist friends in private practice? Are you in academics?
Do they work a ton of nights and weekends?

On average urology does better than EM.

My cousin is a urologist. In the early 2000s he invested in an IMRT consortium on Long Island. He made more money by referring 2-3 patients/mo to IMRT than he did from the entire rest of his practice and he had a busy practice. He was netting 1.1-1.2mil for a few years. More recently he and his partner sold their practice to Lee Capital Partners for 5x gross revenues which was 8 figures. He has to stay on for 5 years and give 33% off the top to his new boss. He’ll retire after that.

 

[cyanide12345678]

Urology makes bank.

There was an episode on the white coat investors with a urologist in Ohio who made 1M+

He was my local urologist for my hospital. NEVER actually on call for us. If you tried calling him for his post OP patients he would call you back at 6 am when he woke up.

All he did was kidney stones and prostate surgeries - high reimbursement low time intensive things and basically made 1M+.

 

[cyanide12345678]

Maybe we need an EM to BSN 3 month online fellowship 🤣🤣🤣

I don’t mind being a school nurse for 200k a year in California 🤣

 

[Apollyon]

He has to stay on for 5 years and give 33% off the top to his new boss. He’ll retire after that.

Dude, that is cruise control for KILLING it!

 

[JacobMcCandles]

Which is an EM doc salary. Medical school is a scam unless you wan to do subspecialty surgery or live somewhere cheap, in which case you don't need a high salary anyway.

What percentage of nurses make that kind of money in the US? It’s a very low percentage.

There’s lots of people out there with minimal training who make way more than the average doctor. But the average doctor makes way more than a lot of people. That’s just the way life goes. I wouldn’t be where I’m at financially if I were a RN. Give me EM pay anywhere over California RN pay any day.

 

[nimbus]

What percentage of nurses make that kind of money in the US? It’s a very low percentage.

There’s lots of people out there with minimal training who make way more than the average doctor. But the average doctor makes way more than a lot of people. That’s just the way life goes. I wouldn’t be where I’m at financially if I were a RN. Give me EM pay anywhere over California RN pay any day.

Yes I’m pretty sure our EM docs make more than our ER nurses.

 

[EctopicFetus]

I make more than my urologist friend in academics, and my job isnt even that high paying for EM

Back in early 00s I bartended a bit during med school. Conference was in town. Served 2 urology attendings from Indiana U. Told me to do urology. Pay for them was $600k plus pension. Bragged about residents taking their call etc. I probably should have listened. Super nice guys unlike most penis docs I have met since.

 

[sirspamalot]

Dude, that is cruise control for KILLING it!

"You're going to hate this one simple trick doctors do to make 750 a year"

#

 

[miacomet]

Maybe we need an EM to BSN 3 month online fellowship 🤣🤣🤣

I don’t mind being a school nurse for 200k a year in California 🤣

Nurses won't let us, or anyone else, in on their deals.

 

[FiremedicMike]

Why do they become NPs then?
Not a serious question, I’m just baffled

Because some of us want to move past the role of bedside. I enjoy the patient interaction and the hands on, but what I enjoy more is looking at the puzzle and putting things together to figure out what’s going on and what to do about it..

And before I get flamed with the “then go to med school“, I’ll offer a few things - I don’t crave independent practice, I have no illusion that I’d be equal to a doc, and I’m just too old to start medical school.

With today's nursing shortage, no way. They prefer it, but most will take an RN and then they can get an online degree (paid for, of course, by the hospital) while working.

But even if they do require a BSN, it's an online degree that takes less than four years.

I was hired with an associates, but had to sign a contract that I’d have my BSN in hand within 3 years. I have a prior bachelors, so my BSN will be about 40 weeks of back to back 6 week courses, 2 at a time, all papers and discussion boards, but by golly I’ll have that illustrious BSN and I’ll immediately be a better nurse (eyeroll).

 

[Kryptocoin]

For all the money urologists make, they're some of the most unpleasant consultants I've consulted. Always seem pissed off and miserable when consulted.

I guess money doesn't buy happiness.

 

[sirspamalot]

You try dealing with

dicks all day and see if you don't turn into one !

 

[dozitgetchahi]

Are European tourists lining up in droves to visit Dallas, Houston, or Chicago? No. That's why they are cheap. Because the quality of life is awful.

Houston is disgustingly hot and unwalkable. You have get on a plane to ski, mountain bike, or go to a nice beach. The traffic is hell.
Ditto Dallas. What exactly does one do in those cities? Can you backpack, hike, walk, ski, lay on a beach? Like, I guess they are OK if you like being stuck in traffic on your way to a bar. But what else is there...to do? I've been and I could not understand the appeal? There was all the inconvenience of a big city and none of the amenities. And no outdoors.

Chicago (worst years of my life) is crime-ridden, uncultured, and once again you have to get on a plane to ski, mountain bike, or go to a nice beach. Bad traffic, mediocre transit. It's great if you love football and beer, but that's it.

I’m trying to wrap my head around all of this.

Chicago and Dallas are cheap? Compared to what, Manhattan and Moscow? Those two cities are actually really ****ing expensive, unless you’re one of those docs who only wants to live in a couple of really huge overcrowded expensive oversaturated hellhole American cities.

If you don’t think Dallas and Houston have any “amenities”…I mean what the hell are you looking for? Houston has one of the very best food scenes in the entire country.

I live in rural Illinois. I hike and backpack all I want. My COL is probably 1/5 of any city you want to live in, so I’m actually able to save money to get on a plane and do all those cool things you describe.

If you think Chicago is “uncultured”, then I guess you think I live in Zimbabwe or something. Then again…I don’t have to pay $3-5k a month for housing, either.

 

[DeadCactus]

It's weird how invested people get in their choice on where to live.

 

[Mount Asclepius]

You only get to live this life once as far as I know. It’s worth it living somewhere you love. I could probably live in a lot of places. It’s not worth it to me though to live somewhere just because it’s cheap with the plan to travel a lot to places I like. Live in the place you like. Extra money saved living in a low cost of living area will make your life easier, but it won’t buy you happiness.

 

[sirspamalot]

Release thyself from geographic restrictions: learn to fly.

 

[emergentmd]

My cousin is a urologist. In the early 2000s he invested in an IMRT consortium on Long Island. He made more money by referring 2-3 patients/mo to IMRT than he did from the entire rest of his practice and he had a busy practice. He was netting 1.1-1.2mil for a few years. More recently he and his partner sold their practice to Lee Capital Partners for 5x gross revenues which was 8 figures. He has to stay on for 5 years and give 33% off the top to his new boss. He’ll retire after that.

The best way to retire early is own something, grow it, then sell out. I know some ER docs who are on the path to sell out their FSER group prob in the low 9 Figures.

 

[miacomet]

The best way to retire early is own something, grow it, then sell out. I know some ER docs who are on the path to sell out their FSER group prob in the low 9 Figures.

Lol are you kidding me? I know the folks who sold (part of) CityMD, which is a powerhouse, and they did not hit nine figures.

 

[emergentmd]

That’s what they will be shooting for and they have lots of sites.

If they get 5x EBITDA then they are well over 9 figures. Healthcare and esp FSER are likely much lower multiple. Even at 3x, they are close to 9 figures. But there are lots of mouths to feed.

A few will be generationally rich, many will retire, most will be able to wind signifantly, some will have to find an er job.

 

[JacobMcCandles]

That’s what they will be shooting for and they have lots of sites.

If they get 5x EBITDA then they are well over 9 figures. Healthcare and esp FSER are likely much lower multiple. Even at 3x, they are close to 9 figures. But there are lots of mouths to feed.

A few will be generationally rich, many will retire, most will be able to wind signifantly, some will have to find an er job.

Are people even getting offers at 3x? They may not want to get their hopes up high. I'd bet somewhere in the 1x (or less) range.

 

[emergentmd]

No way anyone sells for 1x EBIDTA. By the time the ink dries would be 6 months. I think 3x is reasonable, which is what equity goes for inside the group typically.

 

[emergentmd]

Lol are you kidding me? I know the folks who sold (part of) CityMD, which is a powerhouse, and they did not hit nine figures.

Just curious what CityMD EBITDA was and around what multiple they sold for. I would be shocked that they sold for anything less than 3x EBIDTA unless they knew some giant headwinds were coming.

 

[miacomet]

That’s what they will be shooting for and they have lots of sites.

If they get 5x EBITDA then they are well over 9 figures. Healthcare and esp FSER are likely much lower multiple. Even at 3x, they are close to 9 figures. But there are lots of mouths to feed.

A few will be generationally rich, many will retire, most will be able to wind signifantly, some will have to find an er job.

So this is aspirational. Got it.

 

[Splenda88]

Medicine is still ok. The money is not that bad. Just hoping private equity don't take over IM like they are doing with EM.

 

[Splenda88]

Houston is the 4th largest city. Chicago is the third largest city. Dallas metro is also huge, not sure where it ranks exactly.

These places aren’t cheap because people don’t want to live there. People obviously do, that’s why these are the largest cities in the US. The difference is that they are very flat and have continued to grow outside the city boundaries and there is plenty of land available to continue building. The physical terrain is essentially amenable to keep extending outside.

The argument that no one wants to live there is weird. I mean…denver is tiny compared to Houston, Dallas and Chicago. In fact, look at immigration data, California cities have high immigration out into places like Houston and Dallas which are amongst the fastest growing large cities. Follow the money - google how many fortune 500 companies moved to Texas in the last 3-5 years.

So is California really that great when a lot of people are moving out of it to places like boise, austin, Dallas, Atlanta?

And 6000 sqft is nice to have. We often have large gatherings with 15-20 guests at our home - maybe once every other month. The kids get their own play area, the adults have their own area. We often have movie nights in our home with friends in our home theater and we often host game night for several families. Our finished basement is set for entertainment - movie theater, air hockey, basketball hoops, ping pong table, VR gaming set up. Also whenever our family visits, they would stay here. My childhood friend whose fellowship is 3 hours away comes by every 1-2 months and he spends weekends here. Whenever my parents visit, they stay here for months. When my wife’s parents will be here from pakistan, they will stay here, throw in her 2 sisters, then that’s more people. If my sister visits, she will stay here with her 2 kids. We have 6 bedrooms, right now we can fit everyone in our home, once we have 3 kids and all these people visiting, honestly we will start running out of rooms then as well 😂

We’re not outdoors people. I hate hiking, i hate being in the heat. i love central air conditioning. Our entertainment is socializing with friends, we have at least 4-5 monthly events with people. Like today was a movie night with 3 families to watch this new Indian movie that just came out. Day before yesterday my wife hosted her entire clinic for dinner at our home, that was a dozen people. That’s our entertainment.

The last time i tried to ski, i thought i was going to break something even on the bunny slopes. Fyi we have skiing where i live an hour or so away, but it’s just not something I’m dying to do.

Things i cared about when moving last year - job opportunities, low cost of living, excellent school district, major city 1M+ population, things to do, excellent malpractice environment, low volume rural ER within 1 hour of this excellent school district in a large city. So yeah…different strokes for different folks.

I can't imagine having 6000 sqft home. Anything above 3000 sqft will be overwhelming...

 

[Splenda88]

I’m about to pay off a $400k house I bought 3 years ago. No way in hell I could have done that on a teachers pay lol

People are also ignoring purchasing power. I made to decision 2 months that I am going to buy a condo cash for 150-175k next year, and I will have no issue coming up with that money.

 

[cyanide12345678]

I can't imagine having 6000 sqft home. Anything above 3000 sqft will be overwhelming...

It’s manageable. The space comes in handy when you have 15-20 people come over. Though we have a maid come over once every 2-3 weeks so that helps maintain the place.