high-paying specialties that aren't competitive?

[IMG2006]

Originally Posted by miasma

i'm sorry, but damn, this is a sad, sad thread.

Well... wait for 2010 and lets see how you feel when you total the bill on this little venture. Don't forget the interest, and please... don't ever forget that the banks didn't loan you that money so you could help people. Otherwise, we'd all be building houses in Fiji and helping little Johnny get those glasses.
Wait till you see people with 150 bucks worth of hair and nails stiff your attendings on 10 dollar co-pays. Wait till you see people refuse 2 bucks on the medicaid co-pay walk out and light up a pack of cigs that cost more than the meds (which your tax dollars provide) would cost them.
Better yet... wait until your loan company calls you on your cell while you're driving through the ghetto and see people sitting on the sidewalk getting a free ride to do jack squat, while you.... my young student... cannot get federal money to go to medical school... even if you're willing to pay it back.

This guy's attitude is reflective of a larger problem. Or maybe he's just a greedy little snake. Either way, it's a valid question. Trust me... in a few weeks, my salary will just about cover the interest on my loan. I see where he's coming from.

[Miklos]

Originally Posted by solideliquid

I have to disagree there, as $150K is not insignificant. That is what any good psychiatrists should make minimum outside private practice unless they suck as a doctor.

Solide, I think that overall we are in agreement.

What I meant above was that 150k was significantly less than 250k; 100k precisely or 60%.

Originally Posted by solideliquid

Again, no one should go into medicine looking to get rich. But medicine is really the only career where anyone who is a decent physician with a license and an MD behind their name can earn at least $150K anywhere in the country. That is not an arbitrary thing, and dentistry is the only other career that comes to mind.

Once you take alook at the number of hours we put in to get our diploma, finish a residency, get board certified, fully licensed and our practices up and running, you'll find plenty of other professions that reward their practioners at least equally well. College classmates of mine working in law, accounting and corporate finance are being very well rewarded with much, much less education and time spent doing 'scut' at a ridiculously low wage. That much I can glean from the fact that they've got their own homes and are paying down their loans.

[solideliquid]

Originally Posted by Miklos

Solide, I think that overall we are in agreement.

What I meant above was that 150k was significantly less than 250k; 100k precisely or 60%.



Once you take alook at the number of hours we put in to get our diploma, finish a residency, get board certified, fully licensed and our practices up and running, you'll find plenty of other professions that reward their practioners at least equally well. College classmates of mine working in law, accounting and corporate finance are being very well rewarded with much, much less education and time spent doing 'scut' at a ridiculously low wage. That much I can glean from the fact that they've got their own homes and are paying down their loans.

I'm still going to stick by my point. You can look at corporate finance people and investors and say "Gee, that person made like 2 mill last year, hmmm". Yeah while there are people (Mr. Trump) there are even MORE people in that line of work that make NOTHING. AND you have to look at the future, an investor can make 1 million this year, and next year be homeless, losing it all. As an MD, you will ALWAYS have a job, and you will never have to worry about bills (providing you don't buy a ferrari on the amex).

[Miklos]

Originally Posted by solideliquid

I'm still going to stick by my point. You can look at corporate finance people and investors and say "Gee, that person made like 2 mill last year, hmmm". Yeah while there are people (Mr. Trump) there are even MORE people in that line of work that make NOTHING. AND you have to look at the future, an investor can make 1 million this year, and next year be homeless, losing it all. As an MD, you will ALWAYS have a job, and you will never have to worry about bills (providing you don't buy a ferrari on the amex).

Solide,

Is there on average, greater job security for physicians than corporate finance guys?

Maybe, especially if we look at extreme conditions, like recessions, etc..

The numbers you give above (IMO) are unrealistic for many people. Let me give you an example. A friend of mine got a master's in finance. Spent two years in addition to college. His bachelors was in econ, much easier than my science degree. The day he finished school, he got a job starting at 60k. He has since then had time to build his career, and is making a lot more now. He has put far fewer hours into his career (at any stage) than I have. When I get a residency, I'll be pulling roughly 40k first year, a little more second year and if I can moonlight more than that. On a per hour basis, I will be making diddly/squat. That and his loans will long be paid off. Mine won't even be touched until I start moonlighting.

The same goes for the lawyer and the accountant (who is about to make partner -- where the real money is).

My point is, if you have the intelligence to finish medical school and are willing to work hard, there are plenty of other options out there.

We haven't discussed malpractice and dealing with persons with significant character pathologies and working conditions (except as far as hours are concerned above)...

That doesn't mean that one cannot make decent money in this field. However, IMHO, it shouldn't be the primary motivator for anyone.

[solideliquid]

Originally Posted by Miklos

Solide,

Is there on average, greater job security for physicians than corporate finance guys?

Maybe, especially if we look at extreme conditions, like recessions, etc..

The numbers you give above (IMO) are unrealistic for many people. Let me give you an example. A friend of mine got a master's in finance. Spent two years in addition to college. His bachelors was in econ, much easier than my science degree. The day he finished school, he got a job starting at 60k. He has since then had time to build his career, and is making a lot more now. He has put far fewer hours into his career (at any stage) than I have. When I get a residency, I'll be pulling roughly 40k first year, a little more second year and if I can moonlight more than that. On a per hour basis, I will be making diddly/squat. That and his loans will long be paid off. Mine won't even be touched until I start moonlighting.

The same goes for the lawyer and the accountant (who is about to make partner -- where the real money is).

My point is, if you have the intelligence to finish medical school and are willing to work hard, there are plenty of other options out there.

We haven't discussed malpractice and dealing with persons with significant character pathologies and working conditions (except as far as hours are concerned above)...

That doesn't mean that one cannot make decent money in this field. However, IMHO, it shouldn't be the primary motivator for anyone.

Of course they are unrealistic! I was exagerrating, just using those numbers as an example. Yes there are people making 60K out of college or whatever and they get married and buy a house while we can barely afford an apartment. Guess what? After I matched I found out I am pre-qualified for a 100% home-loan ONLY because I have an MD. I can buy a $300K house RIGHT NOW and pay like $3000 in closing cost. Other people have to pay a huge down payment for the same thing. First time buyers sometimes have to put down 40% down.

Yes, we are in agreement that one should not enter med school thinking of all the money they can make. However there are physicians making half a mil a year doing brain surgery so there are exceptions. Let me say this, there is nothing wrong with making money. I am going into psych because I have always been interested in emotions/thinking process/mental health issues. However I DO have a goal in life in terms of finance. I do want to provide for my family and want to send my kids to college. AND I want to drive a nice car whats wrong with that? I said to myself long ago no matter which field I ultimately choose, I would be happy with $200K/yr after some time in practice. That is my goal, nothing wrong with settings goals. It's very easy for people to point fingers and say "those rich doctors don't care about patients, they just want more money to buy that boat", but NOW that I've done med school and about to enter residency there no shame in wanting to get mine and be happy. I got into medicine to change people's lives, but I won't spend MY life eating crackers and tuna-fish.

EDIT: You know, since you put in a real-life example let me share one with you (two in fact). My friend went to the same undergrad school as I did, he graduated with a BA in english. He got a job in a department store and after a while quit to work at a slighlty higher-paying job which is now over too. He never made enough money to move out of hie parent's house or move in with his GF, I estimate he makes like $20K. My wife who has not graduated from college yet went to paralegal school, and is now earning 47K. She should make around 80K when I come out of residency. Moral of the story? Pick a field you love and you won't hate yourself every morning, the money will come in.

[PathOne]

In general, you can make a significant amount of money in any speciality, provided that you are percived as being good, have a solid business sense and are willing to work long hours.

However, if you look at avg. pay per hour, there's generally a close relationship between competitiveness for residencies and pay. Overall, best compensation relative to hours worked is Dermpath. That requires you to either get a residency in Derm (über-competitive) or Path (easier), but also to get a fellowship in Dermpath (über-competitive for both Derms and Paths). Ortho is also well compensated, but hours can be long and it's also very competitive.

However, pay for different jobs can shift significantly over time, due to changes in reinbursement, and insurance premiums. Once, OB/GYN was highly lucrative, but it has taken a severe hit due to insurance premiums (which has also made it less competitive). Most recently, neurosurg has taken a huge hit because of a rapid rise in costs for malpractise coverage.

At the end of the day, I really don't think that one can specifically target a "high paying" speciality, while it IS possible to choose a "lifestyle" speciality, like Derm or ENT. But the vast majority of those residency spots (90%+) goes to grads from US schools.

A final thought is that as demographics leads to an ever aging population, healthcare costs are likely to soar further, leading to increased demands to rein in costs, which could very well lead to a lowering or stagnation in real incomes.

[desai29]

money... money...money

[Miklos]

Originally Posted by solideliquid

Of course they are unrealistic! I was exagerrating, just using those numbers as an example. Yes there are people making 60K out of college or whatever and they get married and buy a house while we can barely afford an apartment. Guess what? After I matched I found out I am pre-qualified for a 100% home-loan ONLY because I have an MD. I can buy a $300K house RIGHT NOW and pay like $3000 in closing cost. Other people have to pay a huge down payment for the same thing. First time buyers sometimes have to put down 40% down.

Great. I'm looking forward to this.

Originally Posted by solideliquid

Yes, we are in agreement that one should not enter med school thinking of all the money they can make. However there are physicians making half a mil a year doing brain surgery so there are exceptions. Let me say this, there is nothing wrong with making money. I am going into psych because I have always been interested in emotions/thinking process/mental health issues. However I DO have a goal in life in terms of finance. I do want to provide for my family and want to send my kids to college. AND I want to drive a nice car whats wrong with that? I said to myself long ago no matter which field I ultimately choose, I would be happy with $200K/yr after some time in practice. That is my goal, nothing wrong with settings goals. It's very easy for people to point fingers and say "those rich doctors don't care about patients, they just want more money to buy that boat", but NOW that I've done med school and about to enter residency there no shame in wanting to get mine and be happy. I got into medicine to change people's lives, but I won't spend MY life eating crackers and tuna-fish.

Solide, I think that you should make whatever money the market awards for your services. In fact, in a backwards way, I am arguing that many physicians are not compensated enough in relation to other professions.

Originally Posted by solideliquid

EDIT: You know, since you put in a real-life example let me share one with you (two in fact). My friend went to the same undergrad school as I did, he graduated with a BA in english. He got a job in a department store and after a while quit to work at a slighlty higher-paying job which is now over too. He never made enough money to move out of hie parent's house or move in with his GF, I estimate he makes like $20K. My wife who has not graduated from college yet went to paralegal school, and is now earning 47K. She should make around 80K when I come out of residency. Moral of the story? Pick a field you love and you won't hate yourself every morning, the money will come in.

I'd agree with conclusion 100%. However, a BA in English is not really marketable, is it? (Contrast this to professional degrees, such as medicine, law or accounting.)

[stiletto]

Dear DoctorMua:

High paying specialties aside from Anesth, Rads and Surg? I can only speak from the internist's point of view -- the following subspecialties in general can potentially get you a pre-tax salary >220,000/yr -- Cardio, Pulmo/ICU, GI, Nephro. Rheum, Endo, ALlergy prob 130,000+. Heme/Onc in between. But then again, the latter specialties are MUCH MORE RELAXED, so they might not be earning big bucks but definitely they have quality time doing other stuff, being with families.

There's a trend in this generation of doctors when it comes to seeking employment/negotiating contracts -- 10-20 y ago everyone negotiated mostly for their salary. Nowadays everyone negotiates for time off so they can spend time with their families.

Also, you have to look at where you are going to live. In LA, you may be earning 250,000/y but man, you cannot prob buy your own house unless you live at least 40 miles from downtown LA, and that is only a 2 bedroom, 2 bath house. Plus you have to deal with tons of traffic, a lot more rude people, poor returns on your insurance contracts partly due to competition and ins co. policies. For the same amount of salary, and you chose to live in Nashville, or Houston, or in any of the southern states, you can live in a mansion, and have a really nice car, and have a good quality of life.

So being rich is relative. Hope this helps.

[usmle259]

Path and Gas are two specialties that can pay high and are still attainable for a Carib grad. Both of these speciaties are semi competitive, despite the high unfill rate this year. I know of a guy from a carib school with a sub 200 step 1 who matched at a well known university program in Anesthesia. Solid scores and good LORS will get you a Path or Gas spot. Rads is a little more competitive, but still not out of reach. I don't know about Gen surg, but it makes less than the fields I mentioned and you are gonna work REAL hard. Path has some subspeciaties such as Derm path and GI path that pay some serious $$$, but the fellowships are super-competitive to get even with 99's on the steps.