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strawberryjams

Working as a FM Doc vs owning a FM practice?

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What do you mean FM has a 'salary' of 300K?  Of course clinic owners make more....................they have equity and their share of 'overhead' is much less than the doctor working and paying about 25-35% in 'overhead.'  

 

Based on my experience; a family doctor working in a non-FHO model; who is working 5 days per week for 48-50 weeks per year; seeing about 35-45 patients should be able to gross ~$350k.  THIS WILL VARY WIDELY; Take off say, 30% overhead, and you are down to $245k; take off expenses such as licensing fees, malpractice, and miscellaneous.   A reasonably hard working family doctor should be able to pull in $220-230k ALL IN .............................. NET..................... BEFORE TAXES......................

 

Anybody who is much higher or lower is an OUTLIER.  And the above doctor is working RELATIVELY HARD.  

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32 minutes ago, booradley83 said:

What do you mean FM has a 'salary' of 300K?  Of course clinic owners make more....................they have equity and their share of 'overhead' is much less than the doctor working and paying about 25-35% in 'overhead.'  

 

Based on my experience; a family doctor working in a non-FHO model; who is working 5 days per week for 48-50 weeks per year; seeing about 35-45 patients should be able to gross ~$350k.  THIS WILL VARY WIDELY; Take off say, 30% overhead, and you are down to $245k; take off expenses such as licensing fees, malpractice, and miscellaneous.   A reasonably hard working family doctor should be able to pull in $220-230k ALL IN .............................. NET..................... BEFORE TAXES......................

 

Anybody who is much higher or lower is an OUTLIER.  And the above doctor is working RELATIVELY HARD.  

Was going to post something similar but you beat me to it. Thank you for a realistic post.  I'm tired of these moronic questions about physician salary. Also if OP is doing med for the money then I honestly hope he invests it all in a real estate bubble which pops.

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Thanks for answering. I am trying to understand the business model of FM clinic. Even with 230k net (the tax is going to be killing). How much does someone make if they own a clinic and can they avoid taxes? The business side of medicine is pretty cool.

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1 hour ago, strawberryjams said:

Thanks for answering. I am trying to understand the business model of FM clinic. Even with 230k net (the tax is going to be killing). How much does someone make if they own a clinic and can they avoid taxes? The business side of medicine is pretty cool.

Owning a clinic vs working for a clinic doesn't change your tax burden in any way. Owning a clinic means you are in charge of your own overhead, whereas working for a clinic owned by others usually involves some sort of arrangement for the clinic to cover your overhead for you, typically by taking a share of your billings. You get taxed on whatever is left after overhead either way. If you're a particularly good manager of your own clinic, you might be able to pay less overhead than if you worked for a clinic you don't own, but any savings are likely to be very small.

Physicians can save money on taxes in various ways by incorporating, but this can be done without owning your own clinic. The net earnings pre-tax are unchanged, while the amount saved in tax is going to be variable and depends on what corporate taxation laws are taken advantage of, and how. Using the $230k figure as an example, taxes would take about $85k in Ontario (which is about middle-of-the-pack in taxation rate). Various deductions available to everyone - such as charitable donations, RRSP, childcare or medical expenses - can reduce this a fair bit on their own. RRSP contributions alone can reduce overall tax burden by at least $10k per year. Holding money in a corporation can allow for income deferment, which over time could reduce the overall tax burden somewhat. Income splitting with a spouse or child is also a fairly common practice to reduce overall tax burden, but is almost certainly being phased out by the current federal government. In any case, none of this has anything to do with owning - or not owning - the clinic where an FP works.

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14 hours ago, ralk said:

Owning a clinic vs working for a clinic doesn't change your tax burden in any way. Owning a clinic means you are in charge of your own overhead, whereas working for a clinic owned by others usually involves some sort of arrangement for the clinic to cover your overhead for you, typically by taking a share of your billings. You get taxed on whatever is left after overhead either way. If you're a particularly good manager of your own clinic, you might be able to pay less overhead than if you worked for a clinic you don't own, but any savings are likely to be very small.

Physicians can save money on taxes in various ways by incorporating, but this can be done without owning your own clinic. The net earnings pre-tax are unchanged, while the amount saved in tax is going to be variable and depends on what corporate taxation laws are taken advantage of, and how. Using the $230k figure as an example, taxes would take about $85k in Ontario (which is about middle-of-the-pack in taxation rate). Various deductions available to everyone - such as charitable donations, RRSP, childcare or medical expenses - can reduce this a fair bit on their own. RRSP contributions alone can reduce overall tax burden by at least $10k per year. Holding money in a corporation can allow for income deferment, which over time could reduce the overall tax burden somewhat. Income splitting with a spouse or child is also a fairly common practice to reduce overall tax burden, but is almost certainly being phased out by the current federal government. In any case, none of this has anything to do with owning - or not owning - the clinic where an FP works.

yeah on a year to year bases it doesn't change anything. Excellent summary (I would just add the children are already out - and the spouse is greatly reduced as well)

 

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17 hours ago, ralk said:

Owning a clinic vs working for a clinic doesn't change your tax burden in any way. Owning a clinic means you are in charge of your own overhead, whereas working for a clinic owned by others usually involves some sort of arrangement for the clinic to cover your overhead for you, typically by taking a share of your billings. You get taxed on whatever is left after overhead either way. If you're a particularly good manager of your own clinic, you might be able to pay less overhead than if you worked for a clinic you don't own, but any savings are likely to be very small.

Physicians can save money on taxes in various ways by incorporating, but this can be done without owning your own clinic. The net earnings pre-tax are unchanged, while the amount saved in tax is going to be variable and depends on what corporate taxation laws are taken advantage of, and how. Using the $230k figure as an example, taxes would take about $85k in Ontario (which is about middle-of-the-pack in taxation rate). Various deductions available to everyone - such as charitable donations, RRSP, childcare or medical expenses - can reduce this a fair bit on their own. RRSP contributions alone can reduce overall tax burden by at least $10k per year. Holding money in a corporation can allow for income deferment, which over time could reduce the overall tax burden somewhat. Income splitting with a spouse or child is also a fairly common practice to reduce overall tax burden, but is almost certainly being phased out by the current federal government. In any case, none of this has anything to do with owning - or not owning - the clinic where an FP works.

Also is it possible to invest in TFSA. Will it help? Also RRSP limit is around 26 grand. This was pretty helpful advice. I thought if a FM doctor bills privately by owning a business, they can make more. For eg. if a doctor buys a clinic for 1 million$ (via loans from a bank) and then he makes around 350k, he can just earn a 100k salary and the rest 250k he can use to pay off the 1 million debt from the bank. Also 100k salary he can contribute 26k to RRSP and then overhead is practically taken care off. In like 4 years, the doctor will own a million dollar clinic which he can pay off eventually. Also corporate tax on the equity is just 15%. That way if he sells it off, he can make more.

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1 hour ago, strawberryjams said:

Also is it possible to invest in TFSA. Will it help? Also RRSP limit is around 26 grand. This was pretty helpful advice. I thought if a FM doctor bills privately by owning a business, they can make more. For eg. if a doctor buys a clinic for 1 million$ (via loans from a bank) and then he makes around 350k, he can just earn a 100k salary and the rest 250k he can use to pay off the 1 million debt from the bank. Also 100k salary he can contribute 26k to RRSP and then overhead is practically taken care off. In like 4 years, the doctor will own a million dollar clinic which he can pay off eventually. Also corporate tax on the equity is just 15%. That way if he sells it off, he can make more.

Thanks for starting the topic - I've been interested in the difference as well. Just to comment on the TFSA: you will still get taxed on what you made even if you deposit it into a TFSA (unlike RRSP). Just that the interest you gain for keeping the money in that account will not be taxed. TFSAs can be used simply for storing money, or used for stocks etc. The current limit is 57.5k if you were 18+ in 2009, and you'll gain 5.5k contribution room each year under current policies. At the current savings interest rate of ~1%, you gain about $600 per year that will not be considered as income for your tax bracket. So not very significant if you're just keeping cash. If you're in the stock market that would be harder to predict but you could theoretically make 10k a year which would not contribute to your income.

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3 minutes ago, Eudaimonia said:

Thanks for starting the topic - I've been interested in the difference as well. Just to comment on the TFSA: you will still get taxed on what you made even if you deposit it into a TFSA (unlike RRSP). Just that the interest you gain for keeping the money in that account will not be taxed. TFSAs can be used simply for storing money, or used for stocks etc. The current limit is 57.5k if you were 18+ in 2009, and you'll gain 5.5k contribution room each year under current policies. At the current savings interest rate of ~1%, you gain about $600 per year that will not be considered as income for your tax bracket. So not very significant if you're just keeping cash. If you're in the stock market that would be harder to predict but you could theoretically make 10k a year which would not contribute to your income.

Thanks a lot. I find the Ontario taxing 85k a year pretty excessive on FM docs who make 230k especially with loans and OSAP to pay off + undergrad debt. It would have been nice if the tax could be avoided somehow legally offcourse.

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12 minutes ago, strawberryjams said:

Thanks a lot. I find the Ontario taxing 85k a year pretty excessive on FM docs who make 230k especially with loans and OSAP to pay off + undergrad debt. It would have been nice if the tax could be avoided somehow legally offcourse.

If you still have tuition credits you can use them for a couple years at the beginning of your staff years as deductions. I'm not too familiar with the details since I transfer mine to my parents, but you can look into it as it has potential to help those early years

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1 hour ago, strawberryjams said:

Thanks a lot. I find the Ontario taxing 85k a year pretty excessive on FM docs who make 230k especially with loans and OSAP to pay off + undergrad debt. It would have been nice if the tax could be avoided somehow legally offcourse.

Keep in mind that while the tax is decently high, it's the same as it would be for anyone making $230k, in or out of medicine. Student loans are a lot, but with our interest rates, it's a fairly manageable sum. Even as a resident, with a far lower salary and take-home, I've made a solid dent in my overall debt load. The main advantage to medicine is that these earnings are pretty much guaranteed, and start at a young age, while other career paths only earn these sorts of numbers if you're top of your field, significantly older, or both. Even in FM, being a physician is a pretty lucrative career and high earnings mean high income tax, no matter how you get there. The high tax burden is the reason to take full advantage of those tax credits though - no one should be paying anything close to that $85k figure in income tax if they're making responsible financial decisions (and maybe giving a bit to charity :P )

1 hour ago, Eudaimonia said:

If you still have tuition credits you can use them for a couple years at the beginning of your staff years as deductions. I'm not too familiar with the details since I transfer mine to my parents, but you can look into it as it has potential to help those early years

Tuition credits are a huge benefit, but don't factor too much into staff income. Most residents run out of credits somewhere in the middle of their R3 year, so an FM doc will run out of those credits pretty early into their first year of practice, assuming they didn't do a +1 year. As an R2, I basically pay zero income tax, which is a major benefit when it comes to paying down debt and moving away from the (cheaper) student life, so even if it doesn't impact my future income as a staff, these credits make a big difference to my overall financial situation and quality of life.

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52 minutes ago, ralk said:

Keep in mind that while the tax is decently high, it's the same as it would be for anyone making $230k, in or out of medicine. Student loans are a lot, but with our interest rates, it's a fairly manageable sum. Even as a resident, with a far lower salary and take-home, I've made a solid dent in my overall debt load. The main advantage to medicine is that these earnings are pretty much guaranteed, and start at a young age, while other career paths only earn these sorts of numbers if you're top of your field, significantly older, or both. Even in FM, being a physician is a pretty lucrative career and high earnings mean high income tax, no matter how you get there. The high tax burden is the reason to take full advantage of those tax credits though - no one should be paying anything close to that $85k figure in income tax if they're making responsible financial decisions (and maybe giving a bit to charity :P )

Tuition credits are a huge benefit, but don't factor too much into staff income. Most residents run out of credits somewhere in the middle of their R3 year, so an FM doc will run out of those credits pretty early into their first year of practice, assuming they didn't do a +1 year. As an R2, I basically pay zero income tax, which is a major benefit when it comes to paying down debt and moving away from the (cheaper) student life, so even if it doesn't impact my future income as a staff, these credits make a big difference to my overall financial situation and quality of life.

I am confused.What is a tuition tax credit?

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18 minutes ago, strawberryjams said:

I am confused.What is a tuition tax credit?

https://www.canada.ca/en/revenue-agency/services/tax/individuals/topics/about-your-tax-return/tax-return/completing-a-tax-return/deductions-credits-expenses/line-323-your-tuition-education-textbook-amounts.html

You get a tax credit for tuition charged by post-secondary institutions. 

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8 hours ago, ralk said:

Tuition credits are a huge benefit, but don't factor too much into staff income. Most residents run out of credits somewhere in the middle of their R3 year, so an FM doc will run out of those credits pretty early into their first year of practice, assuming they didn't do a +1 year. As an R2, I basically pay zero income tax, which is a major benefit when it comes to paying down debt and moving away from the (cheaper) student life, so even if it doesn't impact my future income as a staff, these credits make a big difference to my overall financial situation and quality of life.

Do you recommend we use our tuition tax credits during residency or save them once we are staff?

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12 minutes ago, Dermviser said:

Do you recommend we use our tuition tax credits during residency or save them once we are staff?

Credits have the same value regardless of income level. A dollar today is worth more than a dollar tomorrow. Better to use it as soon as possible.

 

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7 hours ago, Dermviser said:

Do you recommend we use our tuition tax credits during residency or save them once we are staff?

You don't have a choice as to whether or not you use your tuition credits. If you have any income (even if it's through a side gig and not residency) your tuition credits will be used up. If you don't apply for them to be used when you start making money, you will get a refund the following year when you file your taxes.

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31 minutes ago, skyuppercutt said:

You don't have a choice as to whether or not you use your tuition credits. If you have any income (even if it's through a side gig and not residency) your tuition credits will be used up. If you don't apply for them to be used when you start making money, you will get a refund the following year when you file your taxes.

plus there is absolutely no advantage to saving them - it is a fixed rate of money you get back for the amount you paid in tuition - so the question is do you want X dollars now, or X dollars in future. Since you are probably paying loans etc with interest you could pay off the answer is I will take the money now :)

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1 minute ago, strawberryjams said:

Can family doctors incorporate? will that reduce tax burden legally

they are one of the most common types of doctors to incorporate actually. 

and I want to be careful with what you mean by reducing the tax as well here - there simply is no way to earn say after expenses 200,000 dollars or whatever and take it as personal income without paying basically the same amount of tax. You could draw it as salary, take it as dividends from your corporation or whatever - doesn't matter the overall taxes you will pay will be roughly the same. That is by design - the government works hard to try to make it that way.

As it should be on a more country wide tax fairness point of view. Anyone that gets income of X should pay roughly the same same amount of tax (modified by deductions they happen to have etc, etc). Is it a lot of tax? Yes it is - Canada has a lot of thing we spend tax dollars on and it is not cheap. It is the flip side of our subsidized health care, education system (including all the provincial loan systems etc, etc) which we have all enjoyed to get to this point. Not that I like seeing my tax bill ha (I can understand and agree with things I don't personally like happening to me ha),  and you would want to reduce it in line with your other important goals. 

Now that being said there are a ton of ways to defer taxes, and use that to your advantage to grow wealth (income is great but wealth in the long term is more important). For starters you need to save a lot of money because doctors have a short work life relative to others because we are in school forever (or it feels that way), and no pension or other retirement plan at all. 

You can defer taxes by not taking as personal income money and save it for the future - you can do that with RRSPs, or you can do that by leaving it in your corporation and investing it. In both cases you will still pay taxes on the money but it will be either none now, or less now and move that tax bill into the future. That helps the money grow. 

One of the reasons I don't like the term salary for doctors (and there is a long list of reasons why I don't like it) is that ignores key factors of your financial future. You would get quickly into big trouble if you though you earned 200K a year and some how were taking that, pay some tax on it and spending the rest like people in many other fields (like my mom the bus driver with the 65% of last years salary as her pension index to inflation forever - she didn't have to save for retirement). You need to save a relatively massive amount for retirement to start with that isn't considered with a salary mindset (even maxing out your RRSP limit at 24K a year for many doctors is no where near enough). You also would have nothing left for any maternity or paternity leave, time off for any other family emergency and so on. Our corporations allow us to smooth out the amount of money we earn to be more consistent in our working years and retirement which does reduce overall our tax bill - but it also effectively reduces the amount we would earn as a result each year.

 

 

 

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9 hours ago, medigeek said:

Owner >>>>>>>. employee of any form (always)

In the US, employee is the norm and it has caused a crappy shift of direction for doctors. 

Yeah - the loss of control is very damaging. It is always tempting to agree to salary system as they are less work mentally - benefits, pension, no complex incorporation rules - just go to work, and collect your cheque. Great but that ignores the major downside. 

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9 minutes ago, rmorelan said:

they are one of the most common types of doctors to incorporate actually. 

and I want to be careful with what you mean by reducing the tax as well here - there simply is no way to earn say after expenses 200,000 dollars or whatever and take it as personal income without paying basically the same amount of tax. You could draw it as salary, take it as dividends from your corporation or whatever - doesn't matter the overall taxes you will pay will be roughly the same. That is by design - the government works hard to try to make it that way.

As it should be on a more country wide tax fairness point of view. Anyone that gets income of X should pay roughly the same same amount of tax (modified by deductions they happen to have etc, etc). Is it a lot of tax? Yes it is - Canada has a lot of thing we spend tax dollars on and it is not cheap. It is the flip side of our subsidized health care, education system (including all the provincial loan systems etc, etc) which we have all enjoyed to get to this point. Not that I like seeing my tax bill ha (I can understand and agree with things I don't personally like happening to me ha),  and you would want to reduce it in line with your other important goals. 

Now that being said there are a ton of ways to defer taxes, and use that to your advantage to grow wealth (income is great but wealth in the long term is more important). For starters you need to save a lot of money because doctors have a short work life relative to others because we are in school forever (or it feels that way), and no pension or other retirement plan at all. 

You can defer taxes by not taking as personal income money and save it for the future - you can do that with RRSPs, or you can do that by leaving it in your corporation and investing it. In both cases you will still pay taxes on the money but it will be either none now, or less now and move that tax bill into the future. That helps the money grow. 

One of the reasons I don't like the term salary for doctors (and there is a long list of reasons why I don't like it) is that ignores key factors of your financial future. You would get quickly into big trouble if you though you earned 200K a year and some how were taking that, pay some tax on it and spending the rest like people in many other fields (like my mom the bus driver with the 65% of last years salary as her pension index to inflation forever - she didn't have to save for retirement). You need to save a relatively massive amount for retirement to start with that isn't considered with a salary mindset (even maxing out your RRSP limit at 24K a year for many doctors is no where near enough). You also would have nothing left for any maternity or paternity leave, time off for any other family emergency and so on. Our corporations allow us to smooth out the amount of money we earn to be more consistent in our working years and retirement which does reduce overall our tax bill - but it also effectively reduces the amount we would earn as a result each year.

 

 

 

RRSP is pretty pointless imo since they still tax that money when you take out the money from RRSP. Also to make a 24k investment in RRSP we need to have 24K in the first place. Lets say a doctor makes 235,000$ before taxes. After tax, it would be 142k. Almost 92,000 is taxed. So for someone to make 24k RRSP, the doctor would lose 24 k annual income already and it would drop to 118k. Thats less money available for other things. So although the doctor saves 12k on RRSP, he has less money available to spend per year. I do get the fact that RRSP can be invested in stocks, bonds etc but even that will get taxed once you take it out so its basically not a real benefit. I personally dont support this tax policy. It is unnecessarily penalizing people who make money.  I will support a social insurance fund for health care and education so i can see exactly where the tax is going, the government currently has general revenue taxation which isnt a great way to ensure transparency.

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21 hours ago, strawberryjams said:

RRSP is pretty pointless imo since they still tax that money when you take out the money from RRSP. Also to make a 24k investment in RRSP we need to have 24K in the first place. Lets say a doctor makes 235,000$ before taxes. After tax, it would be 142k. Almost 92,000 is taxed. So for someone to make 24k RRSP, the doctor would lose 24 k annual income already and it would drop to 118k. Thats less money available for other things. So although the doctor saves 12k on RRSP, he has less money available to spend per year. I do get the fact that RRSP can be invested in stocks, bonds etc but even that will get taxed once you take it out so its basically not a real benefit. I personally dont support this tax policy. It is unnecessarily penalizing people who make money.  I will support a social insurance fund for health care and education so i can see exactly where the tax is going, the government currently has general revenue taxation which isnt a great way to ensure transparency.

hey couple of points !

first off any money you leave in your corporation is equally going to be taxed when you take it out. It is exactly the same. If the RRSP is pointless then so is every major tool the doctors have for saving for retirement. I would have to disagree with that if for no other reason than it is depressing to think that way ha.

second they actually won't lose 24K in income under that model. Just framing some of the numbers you present - they would earn 235K, put 24K into the RRSP, have 211K left which is then taxed. The resultant tax would be then depend a bit on the province but would be around 79K leaving about 131K to spend. The 24K would then grow in the RRSP tax free for say decades when you are starting out - say 30 years, during which on average based on historical norms it would be worth say 8 times that or now 192K again give or take. The fact that it grows in a tax free environment is huge - I would argue that as well as the relative tax immune corporation structure is exactly the point of why these are so powerful as it avoid drag on the compound interest. Now during retirement you take that money out but you are in a lower tax bracket because you aren't a full time doctor ultimately paying less tax (potentially - in any case it won't be higher as you are already at the highest tax bracket). 

Some of these will always, always boil down to political leanings and approach in our progressive taxation system - the more you make the more your pay and not in a linear fashion. That being said the idea that you can get to that level of income on your own is also simply wrong - I don't like paying 53% tax on my last dollar of income, but I am sure glad that the government paid the roughly 1.0-1.5 million dollars in total education cost to create me and that is beyond what I paid and I refuse to pretend that such subsidization did not take place, and that system is not all connected. In the end the government in Canada is also the source of all my income as a doctor and they want some return on their investment as well. There are many places where this model varies - the US where the cost of education is through the roof and many doctors actually make less suffering under high loan rates to boot, or say Europe where costs are even lower to students but doctor income is also lower (although they have full benefits, pension and so on in many cases). You could argue we are not that bad off at all here. 

Not to say things couldn't be improved of course with respect to government fiscal policy!  I have to say reading their budgets each here is a bit of chore but you can see where most of where things are going.

I will add that overall with proper planning and a good sense of the models out there, any doctor can end of quite well of even with the restrictions. Ha, I want to help people get into medical school, and also help them survive the experience, and have full knowledge of the opportunities once they are done - including the financial ones. It isn't a doom and gloom situation

 

 

Edited by rmorelan

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29 minutes ago, rmorelan said:

hey couple of points !

first off any money you leave in your corporation is equally going to be taxed when you take it out. It is exactly the same. If the RRSP is pointless then so is every major tool the doctors have for saving for retirement. I would have to disagree with that if for no other reason than it is depressing to think that way ha.

second they actually won't lose 24K in income under that model. Just framing some of the numbers you present - they would earn 235K, put 24K into the RRSP, have 211K left which is then taxed. The resultant tax would be then depend a bit on the province but would be around 79K leaving about 131K to spend. The 24K would then grow in the RRSP tax free for say decades when you are starting out - say 30 years, during which on average based on historical norms it would be worth say 8 times that or now 192K again give or take. The fact that it grows in a tax free environment is huge - I would argue that as well as the relative tax immune corporation structure is exactly the point of why these are so powerful as it avoid drag on the compound interest. Now during retirement you take that money out but you are in a lower tax bracket because you aren't a full time doctor ultimately paying less tax. 

Some of these will always, always boil down to political leanings and approach in our progressive taxation system - the more you make the more your pay and not in a linear fashion. That being said the idea that you can get to that level of income on your own is also simply wrong - I don't like paying 53% tax on my last dollar of income, but I am sure glad that the government paid the roughly 1.0-1.5 million dollars in total education cost to create me and that is beyond what I paid and I refuse to pretend that such subsidization did not take place, and that system is not all connected. In the end the government in Canada is also the source of all my income as a doctor and they want some return on their investment as well. There are many places where this model varies - the US where the cost of education is through the roof and many doctors actually make less suffering under high loan rates to boot, or say Europe where costs are even lower to students but doctor income is also lower (although they have full benefits, pension and so on in many cases). You could argue we are not that bad off at all here. 

Not to say things couldn't be improved of course with respect to government fiscal policy!  I have to say reading their budgets each here is a bit of chore but you can see where most of where things are going.

I will add that overall with proper planning and a good sense of the models out there, any doctor can end of quite well of even with the restrictions. Ha, I want to help people get into medical school, and also help them survive the experience, and have full knowledge of the opportunities once they are done - including the financial ones. It isn't a doom and gloom situation

 

 

Excellent points! thanks for your insight.

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