I thought a lot about salary before I made the choice to train in pediatrics. What I discovered was that it's really difficult to get a realistic view of what the future earnings in any specialty will be. The job market is constantly in flux - 5 years ago everyone was excited about the shortage of anesthesiologists and the wide-open job market. Fast forward to the recession and things have tightened up. There is still good earning potential in the field, but less options than just a few years ago. I heard of a urologist who took home <$100k because his practice decided to ride out the economy rather than get rid of staff. I have also heard of an occuloplastics doc netting in the low $100's as business has slowed down. I don't know how many hours either of these physicians worked.
The earning potential of general peds these days is pretty much on par with general internal medicine and family practice. So says the Bureau of Labor Statistics website, the AMGA salary survey, mysalary.com, etc. A realistic mid-career average for any of these fields appears to be $150-170k.
The AAP published a paper just last year that polled starting salaries of graduating residents. The starting salary for part-time employment was around $80k, full time was about $105k and hospitalist was about $120k. When I dig up the paper again, I'll link it to this forum.
Without question, these salaries are considerably lower than starting figures for ENT (mid-200's at my med school), anesthesiology (low-200's at my school), radiology, etc. Then again, while general peds certainly has its stressful, challenging aspects, pediatricians are not dissecting near the carotid or keeping people alive during heart surgery on a daily basis. So there's a trade-off.
From what I can gather, if you want to be a pediatrician but still want to make the big bucks, it's possible, but there's always a trade-off (as there should be). It's been mentioned already, but critical care, neo, and cards all have high earning potential but a different lifestyle and longer training than general peds. At my med school, starting salary in these fields was around $180k-230k. That's with state benefits (very good) and bonuses not included. Mid-career physicians/professors were earning in the mid-upper $200's. Such salaries are consistent with a lot of the published survey data on these fields. Those guys also spent the night in the hospital, routinely flew across the state to attend clinic, and dealt with the emotional demands of critically ill children. They earned their salaries.
Some people could make themselves do anything so long as they are being compensated well. If that's the case, pick a high earning field like rads or anesthesia and cross your fingers that health reform doesn't slash your salary too much or that CRNAs don't make you obsolete (a constant worry of my friends in those fields, though I'm not sure it's really substantiated).
According to the AAP, the average pediatric resident will graduate from training with $159k in education debt (this includes spouse debt, as well). Personally, I have $119k and my wife has about $35k from nursing school, so we're right around average. I picked pediatrics because I could envision myself happy on a daily basis using my knowledge of medicine to heal children. Because the majority of the physicians in the field know the importance of balancing a demanding job and family responsibilities. Because people in the field are generally pleasant and easy-going. And because even $130k is still way more than my father made in his early 30's as a engineering assistant.
I have a lot of very smart, motivated friends who work in the pharmaceutical industry, for engineering firms, as research assistants and I don't think that they will be earning more than 100k in their 30's. Medicine also has considerably better job security than most other fields. It's unlikely that you'll show up at the hospital where you have been working for 20 years and be informed that you have been laid off. In most other careers, job security sucks these days.
I don't think that salary should be the sole motivating force for picking a career in medicine. To be honest, I get the occasional pang of regret that I didn't pick a high earning field - I was a really competitive applicant and could have almost certainly matched into rads or anesthesia. However, I don't like the part of my personality that is only money-driven. For me, a career in rads or anesthesia would have only perpetuated that financial tunnel vision because I simply didn't enjoy the work as much while I was in med school.
Bottom line - if you want to operate on someone's neck, pick ENT. If you want to do some cool procedures, look at films and have less patient contact, choose rads. If you have an interest in adult critical care and like the operating room, consider surgery or anesthesia. If you want to care for sick kids and communicate with their parents, choose peds.
If you want a good laugh, go the dermatology forum. Some of them are whining about their low earning potential of only $300k (one poster said he wishes he would have just chosen to be a hedge fund manager).
