Any family med docs regret switching careers as a non trad?

[windsormd1]

13 hours ago, Wachaa said:

@windsormd1 I'm assuming it is because spouse pays taxes according to his own personal tax bracket on the 95k part of the household income. Still not totally 21k/ month, but roughly there.

Exactly! 250k is about 150-155k after taxes in ON and even 100k is about 70k after taxes. $225k/12 = 18.75k monthly , let’s round up to 19-19500 after deductions 

[frenchpress]

22 hours ago, Wachaa said:

I think therein lies the problem with your plan. If you go into Rural (and I mean rural like...5 acre horse ranches within 5-10 km of your work place), you need to enjoy doing hospital work and possibly cover ER, in-patients, long term care, take overnight call. Otherwise, who else is going to do it? There is almost no chance you can do 4 days a week AND still make a great living. If you do four days a week you're likely looking at <200k after overhead. You'll beg on both knees to find a locum to cover for you if you're away long periods of time. There is literally no incentive for your colleagues to cover you because they're likely overworked themselves.

In most rural places like the ones I've described, you're likely looking at 60 hours per week, in my honest opinion. Typically 8AM rounds at hospital, 9-5PM clinic, 5-6PM hospital, and then possible overnight coverage. Weekends: round on hospital patients, round on long term care, possibly overnight coverage or ER coverage.

 

If you're looking at Victoria/ Nanaimo, I don't know the real estate situation there, but I suppose you can get away with doing only clinic work. However, their walk in clinics are shutting down in spades due to poor remuneration. Meanwhile patients there have a huge waitlist problem and cannot find a family doctor.

I agree with this, I’m not sure OP that you’re being realistic with your expected income given that you only want to work 32 hours a week, especially in your first few years of practice. The workload for full service GPs in the valley, in my experience, is on average pretty high.

Have you looked up the fee schedules for family medicine in BC? A standard GP visit pays ~$31 (goes up a bit for infants and patients over age 50, to a max of $47 for someone over 80). If you see 6 patients an hour (10 minute appointment slots) and work 32 hours a week, 11 months a year, that’s ~285k before overhead and before taxes. And that’s assuming you can do all your charting and paper work, review your labs, write your consults, etc. in those 10 minute appointment slots. In reality, you may need to work at least 1-2 hours a day in addition to do all that ‘unpaid’ work associated with appointments that you can’t bill for, likely more when you’re still green and figuring things out. Obviously that’s a very rough estimate. Everyone’s practice is different. There are procedures and counselling or chronic disease visit codes that will pay more, they also have more overhead associated with them and/or they take longer. And you can diversify and add other types of practice, like nursing home visits or house calls, but again, the more it pays the longer it’s likely to take. 

There are a range of options depending where in the valley you want to be. In Chilliwack you can still maintain hospital privileges, which many of the docs do, and that certainly increases billing opportunities. But it also increases your workload a lot, because you need to round pretty much daily on patients. If you do hospital work and you want to be able to take vacation or have weekend off, etc. then you’ll need to join a call group in addition to getting locums to cover you in the office. And when you’re in a group like that, you need to negotiate time off, because people can’t all leave at once. Same for obstetrics. If you want any semblance of a work life balance you’ll need to join a call group, and that means compromising on vacation, days off, etc. Someone has to work holidays and sunny weekends.

The family docs in Abbotsford by contrast don’t have hospital privileges, it’s pretty much all hospitalists working there with the exception of obstetrics. So if you’re doing full-service GP in that community it’s much more likely to be office-based, which is going to increase your overhead relative to your billing. Or you can do something like hospitalist, which is a totally different ball game (and not one I know much about) - but that doesn’t sound like it is where your interests lie so much, and you won’t find those sorts of positions in the more rural hospitals much. 

There are extra financial incentives for rural physicians, but you’d need to go a bit further out in the valley for a lot of those I believe. Quite a few docs commute to Hope, for example, but that adds 1-2 hours of driving to every day you work if you’re living down in the valley.

So let’s say you actually end up only making ~175k a year take home for your portion. Great income, sure. It’s 100k more than you make in your current job. But at that rate, you’re looking at having to work for 4.5 years just to make up for the lost income over 6 years of training (and assuming you would not have advanced in your current career in that time). That doesn’t include tuition, etc. And don’t forget that once you’re a doctor you won’t have a pension or benefits, which further eats into how far that take home pay will go.

[MountainAmoeba]

On 7/26/2020 at 12:02 AM, offmychestplease said:

I can't answer the questions you posed but getting into medical school is extremely competitive in Canada. Some people have planned this for years to never get in or get in after applying many times. Have you written the MCAT? Do you have a high GPA - or do you need to do an additional degree to raise it up? Do you have a strong EC record? Do you interview well? Etc. It also takes 1 year from application to starting medical school in an application cycle. These are all important questions to consider. Also, the vast majority of applicants apply 2 or 3 (sometimes more) times before getting. Once you are in, you have to also add another 4 years of medical school and 2 years of residency if you want to do FM. If you change your mind and want to do literally any other field in medicine that's another 3-4+ years. 

 

So, realistically you are looking at 10 years from today to become a family doctor assuming you get in.  

This is a useless post. Man. Get off it. Also news flash. Some people are competitive and get in with one application without upgrading. Also residents make cash. So it’s really only the investment of Medical School, especially for people considering family medicine where the residency is typically more civilized than most others. 

[bearded frog]

3 hours ago, MountainAmoeba said:

This is a useless post. Man. Get off it. Also news flash. Some people are competitive and get in with one application without upgrading. Also residents make cash. So it’s really only the investment of Medical School, especially for people considering family medicine where the residency is typically more civilized than most others. 

What are you talking about? Obviously some people have 4.0s and would rock the MCAT and that makes the decision easier. But those people also probably have relatively well paying jobs and fulfilling career prospects. If you're fairly advanced in your career where you're hemming and hawing about going back to medical school, you're probably making more than a resident does, so even if you can get in on the first go, and go to a 3 year program and do FM that's still 5 years of lost earnings - tuition investment for the expected increased earnings of FM, but that needs to be amortized vs expected earnings in their current career, of 5 years of income plus assumed raises as one's career advances. If you're in a dead end career with low income and good credit and few dependents a 4.0 GPA and the ability to rock standardized tests, the math is easy, but I think that's the exception as opposed to the rule.

[MountainAmoeba]

5 hours ago, bearded frog said:

What are you talking about? Obviously some people have 4.0s and would rock the MCAT and that makes the decision easier. But those people also probably have relatively well paying jobs and fulfilling career prospects. If you're fairly advanced in your career where you're hemming and hawing about going back to medical school, you're probably making more than a resident does, so even if you can get in on the first go, and go to a 3 year program and do FM that's still 5 years of lost earnings - tuition investment for the expected increased earnings of FM, but that needs to be amortized vs expected earnings in their current career, of 5 years of income plus assumed raises as one's career advances. If you're in a dead end career with low income and good credit and few dependents a 4.0 GPA and the ability to rock standardized tests, the math is easy, but I think that's the exception as opposed to the rule.

I think the OP had a specific question, and rather than respond to the posed question the respondent came in with their own agenda. Twice in the thread. We get it. Everyone gets it. It’s hard to get into medical school. 
 

The op is asking if it’s worth the effort. It might be a useful statement, but it’s not a useful response to the question.

[offmychestplease]

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[offmychestplease]

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