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Why do individuals say that becoming a doctor for the money is not worth it?


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Hello everyone. I am just wondering, is there anyone that you know (or perhaps even yourself) whose primary motivation for pursuing medicine is the pay. On a related note, is there anyone here who started out wanting to go for medicine for financial reasons but now has different motives? Of course financial security is important but what I mean here is that it's the PRIMARY reason. Additionally, why is it that people say going into medicine for the salary isn't worth it? I personally can't think of any other jobs that give you a relatively risk free salary as high as medicine. By "risk free" I mean lawyers, business owners, etc. can just end up not being busy enough since it's in the private sector. Compared to let's say a oncologist in a hospital, the doctor will surely have patients and will surely get a very high salary compared to the general public. Is it untrue to say that medicine has more financial stability compared to other high paying jobs? 

 

Please note however, that this is not my motive for pursuing medicine nor is this post a troll of any kind. I just want to have an open discussion about monetary gain as it relates to medicine because it's often not discussed due to the belief that doctors are supposed to be altruistic and not discuss the monetary benefits of medicine. 

 

Also, I am not sure if this post belongs in here or the "lounge" section. My apologies in advance if this is in the wrong place. 

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People say not to pursue medicine for the $$$ because

1) Time-value of money: it takes a lot of years to eventually reach the attending salary, whereas with other professions you can start increasing your net worth from way earlier without all the debt you incur for med school. You will feel and live poor asf throughout your 20s, and possibly early 30s if you start Med School late. That being said, chances are your salary will be 3x-5x more than most people, so within a decade as an attending your NW should possibly skyrocket past theirs. 

2) People don't want doctors to pursue the profession for the money (as a primary motivator) for the same reason why Pharma gets so much slack for doing business practices that plenty of other big companies do in other industries, and get away with. The healthcare industry provides products/services that affect people's lives directly, and so there is a greater emotional attachment to that service/product been given with good intentions only. You don't want a doctor to ever choose profits over possibly making positive health outcomes for their patients, even if its their freedom and liberty to do so. And so, you want doctors to be willing to make sacrifices (such as on their income) in order to maximize health outcomes for the population as a whole. If you go into Medicine for the money, you will be quite frustrated in that regard.

*Just to clarify my 2nd point, I am saying that some people say these type of things as they want to dissuade those who seek money as a primary motivator from getting into Medicine, because they might not be compatible with what people want/expect out of doctors

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You won’t be a good and humane physician if you study medicine for the sake of money. You will end up accepting activities that are beyond your scope and are illegal when money is the root of those. That is why extra curricular activities are important, med schools need to see your “humanities” side and that it must flourish. A good balance of paid and unpaid is good but if you cannot do unpaid activities, ask yourself why you still want to pursue medicine. I believe that being a physician is a noble profession, one must have the right motive and attitude to get in.

 

However, the sad reality is that 60% of matriculants said that they study medicine because of financial reasons. You can find the article online using the keywords I mentioned.

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1 hour ago, Billdolla said:

Hello everyone. I am just wondering, is there anyone that you know (or perhaps even yourself) whose primary motivation for pursuing medicine is the pay. On a related note, is there anyone here who started out wanting to go for medicine for financial reasons but now has different motives? Of course financial security is important but what I mean here is that it's the PRIMARY reason. Additionally, why is it that people say going into medicine for the salary isn't worth it? I personally can't think of any other jobs that give you a relatively risk free salary as high as medicine. By "risk free" I mean lawyers, business owners, etc. can just end up not being busy enough since it's in the private sector. Compared to let's say a oncologist in a hospital, the doctor will surely have patients and will surely get a very high salary compared to the general public. Is it untrue to say that medicine has more financial stability compared to other high paying jobs? 

 

Please note however, that this is not my motive for pursuing medicine nor is this post a troll of any kind. I just want to have an open discussion about monetary gain as it relates to medicine because it's often not discussed due to the belief that doctors are supposed to be altruistic and not discuss the monetary benefits of medicine. 

 

Also, I am not sure if this post belongs in here or the "lounge" section. My apologies in advance if this is in the wrong place. 

The reason people say don't do medicine for the money, is because the pay while in your 20s and 30s is not as good as similar jobs. With all this being said, it takes different skill sets to succeed in different fields, so, for many people, medicine will be the best paying career for them because they would not have the skillset to succeed in a higher paying field. However, for those who can do well in multiple fields, medicine isn't the highest paying one. 

Typically, medicine is often compared to law, finance (IB/PE/Hedge Funds), consulting and tech (software engineering/data scientist)

These jobs all entail higher degrees of "risk" than medicine, but even when people in these positions lose their jobs due to a recession etc., they often quickly recover and find similar high paying jobs in different fields. 

In medicine, typically you are paying tuition for 8 years, you start working at the age of 26 making 65k a year going up 5k a year. Fellowship typically pays similar to residency salaries and many people pursue graduate degrees either before medical school or after. Residency varies depending on your specialty, can be as low as 40-60 hours a week up to 80-100 hours a week in surgical specialties. Most specialists in Canada if working a 60 hour work week would likely make 300-700k depending on specialty. 

All this time, someone who is in finance in the US will be starting at 130k USD straight out of undergrad, climbing 30-40k a year. Yes, many people fall off the track, but the majority will make it and have great exit opportunities. IB and PE both are heavy on the hours with banking 80-100+ and PE slightly less. 

The opportunities in tech are unreal, there may be a bubble, but currently software engineers make 180-220k USD fresh out of undergrad "all in" working for the big tech firms like Google/FB/Snap/Pinterest. These salaries climb about 20k a year as well with engineering managers around age 30 making 300-350k a year. Hours are unreal in this area, 40-50 hours a week are the standard at the big firms, startups will work much harder.

Law takes about 7 years and in Canada, starting salaries are around 120-130k in big law, climbing 15-30k a year, with partners making 600-1mil+. In the US, big law starts at 185k USD climbing even more steeply. Hours are pretty bad in big law 60-90 hours are the standard.

Consulting works around 60 hours a week, travels a lot (which is usually a hassle), but they start at 70-100k climbing about 25k a year as you climb the ranks until you are out. About 5-10% will make Partner, where they earn between 500k-1mil+ a year with 10-20% of partners making 1.5-5mil a year. 

So in the lifespan of a career, medicine probably doesn't do too bad, the ceiling isn't as high as other fields, but the average doctor doesn't do too bad. It is difficult to compare lifetime earnings as well because medicine tends to be more stable, while these other fields are prone to highs and lows. However, in your 20s and 30s, you make way less than other fields. With the right investing, someone in any of these other fields would make several times what a physician makes. You need something else motivating you or else it will be a long and tough residency. 

I think doing in medicine in part because of the money is definitely reasonable and should be less stigmatized in medicine. Doing medicine mostly because of the money is probably just a mistake for most people. Ultimately what the public wants is doctors who don't mistreat patients for money. As long as you are not someone who does that, you are good. 

It is simple economics, the reason the government, aka the people, bother to pay doctors salaries several times your average worker is because they want to draw talent who would otherwise go into fields like law, finance, consulting and tech. 

 

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38 minutes ago, biochem4 said:

You won’t be a good and humane physician if you study medicine for the sake of money. You will end up accepting activities that are beyond your scope and are illegal when money is the root of those. That is why extra curricular activities are important, med schools need to see your “humanities” side and that it must flourish. A good balance of paid and unpaid is good but if you cannot do unpaid activities, ask yourself why you still want to pursue medicine. I believe that being a physician is a noble profession, one must have the right motive and attitude to get in.

 

However, the sad reality is that 60% of matriculants said that they study medicine because of financial reasons. You can find the article online using the keywords I mentioned.

You are absolutely right that humanity and humility are the very important for medecine practice. I am not so sure, however,  whether the volonteering is a flawless indicator of altruism since some people might do it just to have an outstanding extracurriculars list for medschool entry :) In addition, focus on EC puts students from lower income families in disadvantage because  on many instances they need to start working early (with current cost of living it means working a lot) and as a result might not have time/energy to volonteer during undergrad as mach as someone with a family financial support would do. Once they have this strain released they might become very compassionate doctors. :)

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44 minutes ago, Edict said:

It is simple economics, the reason the government, aka the people, bother to pay doctors salaries several times your average worker is because they want to draw talent who would otherwise go into fields like law, finance, consulting and tech. 

It's a nice breakdown of high-paying careers.  However, I think proximity to the US is a bigger factor for physician pay in Canada - and in the US I believe the economics is partly driven by the even higher tuition costs (with limited supply of doctors - hence IMGs).  The "exodus" of Canadian doctors stopped when pay was increased in the 2000s.  Even a major country like Germany loses physicians because of relatively lower pay.            

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Money isn't bad in medicine but it's vastly over-estimated. Here are some rough numbers for a average family doctor career compared to a nursing career.

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  • 4 years of medical school = 25k tuition/yr + 50k lost wages/year = 300k down compared to nurses by the end of medical school. There is also debt that is accrued on top of this (especially with loans from pre-med), and/or a loss of other income opportunities/investing so we'll round up to 330k. R1s and R2s take home about 45k/yr while paying for expensive board exams, so they're continuing to build debt; by the end of residency it's closer to 350k down in earnings compared to a nurse.
  • The important question now: How long does it take the average family doctor to match a the lifetime earnings of a nurse?
  • Average family doc is grossing 250k/yr and after tax it's roughly 150k/yr. Nurse grosses about 70k/yr and takes home about 50k/yr.
  • With a 100k difference in take-home pay, a attending family doc would take about 4 years to start out-earning a nurse after residency. That's a total of 10 years to catch up assuming the nurse does not take on admin roles or change to become a NP. If he/she does, the family doc might take closer to 12-18 years to catch up, i.e. mid-late 30s by the time.
  • During that time, there are many intangible costs, i.e. sacrificing your 20s-30s studying hard and working long and odd hours for no to little pay. Occasionally being relocated far away from your friends, family, and maybe even your partner. In comparison a nursing career has much better protected time and there's almost no risk of needing to train in a far off province.

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The reason many doctors live great lifestyles is because they graduated at a time when tuition was low, houses were cheap, and probably had great parental support. If you're coming from a lower socioeconomic background, you can rest assured that you'll eventually live comfortably. But if you compare a family doctor's earnings to a good software engineer or 'business' (high end finance career/consulting), the numbers are pretty bad.

And to answer your question about people who come into medicine purely for the money: Yes I know a few of those individuals. 100% of them regret their decisions because they've ran the numbers. They're mostly spending time figuring out how to work the least for the most money--admirable maybe in other fields but appalling and even dangerous in medicine. Luckily there's not many of these people; spending years of your life studying tedious basic sciences and knowing that there's a long road ahead tends to weed out most of them.

Lastly, I just want to say that I don't think there's anything wrong with being partly motivated by money to pursue medicine, as long as it's not the only or main motivator. Some people like to romanticize or idealize medicine--I find that those are rarely the people that grew up struggling. I don't recommend listing this on a personal statement or mentioning it in an interview directly though haha.

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2 hours ago, Edict said:

All this time, someone who is in finance in the US will be starting at 130k USD straight out of undergrad, climbing 30-40k a year. Yes, many people fall off the track, but the majority will make it and have great exit opportunities. IB and PE both are heavy on the hours with banking 80-100+ and PE slightly less. 

Not that many people are going to get a finance job straight out of undergrad. 

2 hours ago, Edict said:

The opportunities in tech are unreal, there may be a bubble, but currently software engineers make 180-220k USD fresh out of undergrad "all in" working for the big tech firms like Google/FB/Snap/Pinterest. These salaries climb about 20k a year as well with engineering managers around age 30 making 300-350k a year. Hours are unreal in this area, 40-50 hours a week are the standard at the big firms, startups will work much harder.

Again, not all that typical. And very competitive. 

2 hours ago, Edict said:

Law takes about 7 years and in Canada, starting salaries are around 120-130k in big law, climbing 15-30k a year, with partners making 600-1mil+. In the US, big law starts at 185k USD climbing even more steeply. Hours are pretty bad in big law 60-90 hours are the standard.

Most law students aren't jumping right into "big law" and the vast majority of lawyers are not with big firms making high six figures. 

2 hours ago, Edict said:

Consulting works around 60 hours a week, travels a lot (which is usually a hassle), but they start at 70-100k climbing about 25k a year as you climb the ranks until you are out. About 5-10% will make Partner, where they earn between 500k-1mil+ a year with 10-20% of partners making 1.5-5mil a year. 

What kind of consultants? 

2 hours ago, Edict said:

So in the lifespan of a career, medicine probably doesn't do too bad, the ceiling isn't as high as other fields, but the average doctor doesn't do too bad. It is difficult to compare lifetime earnings as well because medicine tends to be more stable, while these other fields are prone to highs and lows. However, in your 20s and 30s, you make way less than other fields. With the right investing, someone in any of these other fields would make several times what a physician makes. You need something else motivating you or else it will be a long and tough residency. 

I don't think doing medicine "for the money" makes a whole lot of sense, but I really don't think it's realistic to suggest that many many under-40 people in the job market are making way more. It does provide for a very comfortable amount of income, especially if you're not overly profligate with your money. The residency-to-staff transition is nothing short of astounding financially, e.g. I can sit down and read a few hundred EKGs over a few hours and bill $4k. Generally speaking it's much busier in wholly different ways, but the "average doctor" does pretty well, especially compared to most people. We tend to compare ourselves to our peers first and foremost, but we do well regardless. And while being motivated by money isn't really enough on its own, it is MUCH easier to enjoy what you're doing when you are well paid for it. So, for example, when yesterday the ERP called me with no less than four consults in emerg in the middle of the afternoon, I can't say my thoughts about it at all resembled how I would have felt as a resident. Also, weekend dialysis. 

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It's pretty obvious that most MDs make a very good living, and there aren't so many professions that would allow you to make as much as a physician or surgeon. Financially, I'm pretty much sure it is worth if for majority of people who pursue medicine.

However, money shouldn't be the main reason IMO for the following reasons (just a few reasons I can think of right now, but there are many more):

- your youth devoted to studying. UG +/- something else, then med school, then residency (2-6 years) +/- fellowship +/- advanced degree depending where you can/want to work. I've heard of cardiologists doing 2 fellowships + advanced degree for a job. (4 years of UG, 4 for MD, 3 for IM, 3 for cardio, 4 years of fellowship, 1-3 for advanced degree). You do the math. Time is not something you get back with money.

- It's pretty hard to do something you hate your entire life with such a long training. There are people who stop after med school and move on to other things in life. Then, there are people who carry on with residency for whatever reason (feeling stuck? feeling like they can't go back? too much debt?) but I sometimes wonder why they are in medicine. Fortunately, they tend to be rare. A friend of mine told me she worked with an anesthesiologist who hated his job, so did everything super fast because he just hated his job, but still does it for the money. I mean, 400k of continuous cashflow vs restarting in something else with a much lower wage. I can understand his decision.

- while your non medical friends will have moved on, you will be leading a much more busy and irregular life. E.G. some of my friends are accountants. They work pretty hard, like 50-60 hours. But when they go home, they are done. I'm in my late 20s, and I'm a junior resident. I have to work close to that amount if terms of hours + calls + study time. You get tired after a while. In surgery, the hours are worse. Once residency is done, staff physicians obviously still do calls. The surgeon on call will have to do the 3 AM emergent case even if they haven't slept much the night before. The ICU staff will have to go in at 3 AM to take over the unstable patient. Most jobs won't require you to do this.

- it's a long process from which you'll a lot from, but everyone in the medical field loses a bit of their humanity with time - for some, only a bit, for some, they lose it entirely. You'll see a lot of things that happen, but shouldn't have happened that way, ethically speaking, or sometimes clinically speaking. With time, you start to get more more numb because you can't do anything, and it wouldn't really change anything. I've seen physicians so burnt out and/or completely cynical. They were probably once upon a time wide-eyed empathetic and curious premeds/med students - kinda hard to imagine...

- the intense stress and disappointment/futility sometimes. The first time a patient and coded right in front of my eyes while I was rounding... Having to call the code, and lead the code until someone more senior arrives.... That took 3-4 minutes during which I felt extremely awful, but you can imagine these 3-4 minutes felt like hours for me. The patient died later that day. It was my second patient who died that day, and there was another patient I suggested palliative care the same day. That day felt pretty shitty. My friends doing other things don't have to deal with this kind of stuff.

- the babysitting: as someone who held other jobs before, I feel like it is a common theme in many Canadian schools to think that med students (and sometimes residents) cannot think on their own and are kind of thought of as babies. My older peers really hated that also - going from a full grown adult in the 30s doing their jobs independently and now being treated like a kiddo. Now as a resident, it's not as bad, but still, especially as a junior, I'm still working in a setting of lesser power differential, where I have to do some of the work, smile, not stir shit up, make sure I'm appreciated.

 

Anyways, your question is absolutely legit. So here is my answer.

Do know that IT ABSOLUTELY IS A REWARDING CAREER IN MANY MANY WAYS.

The money for sure is decent when everything is done, but if you hate medicine and you mainly do medicine for the money, you can probably still finish med school and residency and work as a MD, but pretty sure that would be a horrible decision leaving to a life of regrets.

cheers

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My brother went into computer engineering and finished it where as I went to med school. He does much better than me and has for a long time. 

 

Medicine will pay a decent salary but it has no pension or benefits, no protected vacation time, and it basically subject to change by the government at any time. Most MDs make a decent living, hardly any are rich. It’s a long haul and may countless hours working for pennies (4yrs Ug + 4yrs med + 5yrs min speciality residency) just to finally earn what your friends likely did 10 years before you. 

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21 hours ago, A-Stark said:

Not that many people are going to get a finance job straight out of undergrad. 

Again, not all that typical. And very competitive. 

Most law students aren't jumping right into "big law" and the vast majority of lawyers are not with big firms making high six figures. 

What kind of consultants? 

I don't think doing medicine "for the money" makes a whole lot of sense, but I really don't think it's realistic to suggest that many many under-40 people in the job market are making way more. It does provide for a very comfortable amount of income, especially if you're not overly profligate with your money. The residency-to-staff transition is nothing short of astounding financially, e.g. I can sit down and read a few hundred EKGs over a few hours and bill $4k. Generally speaking it's much busier in wholly different ways, but the "average doctor" does pretty well, especially compared to most people. We tend to compare ourselves to our peers first and foremost, but we do well regardless. And while being motivated by money isn't really enough on its own, it is MUCH easier to enjoy what you're doing when you are well paid for it. So, for example, when yesterday the ERP called me with no less than four consults in emerg in the middle of the afternoon, I can't say my thoughts about it at all resembled how I would have felt as a resident. Also, weekend dialysis. 

Very true, but I would actually argue that these finance/consulting/big law/software eng jobs are just as difficult as getting into med. From a look at my peers not in medicine, again, this is anecdotal, but a huge percentage of them have gone into these subfields I mentioned. All of my good friends from high school are in one of these fields above, multiple in software in the US, multiple in finance/PE in the US, some in consulting in Canada/US, a few in law in Canada likely to end up in big law. These people were similar to me academically and socially. Many of them went to good undergrads in Canada, target schools/programs but again it isn't like they all went to an ivy league school or anything. 

Without a question these areas all take a different skill set which many would be doctors may not have, but I believe these fields are comparable from a competition ratio point of view and there is a significant enough overlap that a percentage of each field could easily have found themselves in a different field. 

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