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Why is plastic surgery, opthalmology and dermatology competitive?


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14 minutes ago, offmychestplease said:

Dermatology - INSANE money and AMAZING lifestyle and AMAZING jobs and TOP prestige

in AB Dermatologists can make $1,500,000 - $2,000,000+/year on govt billings alone, and you can increase this if you do cosmetics

lifestyle of a dermatologist is unmatched - no call, no emergencies, can work 9-4 in a chill clinic 

no need for any fellowship, there are so little derm spots = such a small number of derms in the country = insanely good market anywhere in Canada

 

Ophthalmology - INSANE money (if you do retina) and AMAZING lifestyle (for surgery) and TOP prestige

in AB Opthamologists doing retina can bill $2,000,000+ on govt billings alone, have a chance to also expand and do cosmetic eye procedures, contacts, etc

you have to endure 7 years of hell (surgical residency + fellowship), but after, there is no better lifestyle in all of surgery than Optho...can work 9-4 if you want, no call

 

Plastic surgery - INSANE money and AMAZING jobs (in relative to surgery) and TOP prestige 

if you do cosmetics plastics, can make $2,000,000+ but it takes time to set up a practice, large overhead, clientele hard to please, etc

there is demand for plastics in non-metro areas, so it is the best field for surgery for jobs

"cool" factor of being a plastic surgeon and interesting procedures 

 

Medical students are not dumb....there is a reason that derm/optho/plastics are ALWAYS the most competitive fields to enter and it's because those 3 fields are the best bet in all of medicine for INCOME + PRESTIGE + LIFESTYLE (in case of derm and for optho/plastics in relation to other surgery fields)

No way they make that much.... I know academic dermatologist /plastic surgeons make as much as any other specialist... lolI have never heard of those numbers lol

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1 minute ago, offmychestplease said:

you're right but either way even if you don't make a single dollar in private, it's still possible to pull that in derm in AB

Definitely, Derms get paid quite well in Ab. But don't forget, often in some practices the billing can be done through one providers MSP number.  

A local derm colleague who does locum in alberta confirms this, that their billings are done through the clinic owner's #, and then takes the overhead cut from the billings. This is likely very much the case for the docs making >2million in public MSP billings.

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39 minutes ago, JohnGrisham said:

Definitely, Derms get paid quite well in Ab. But don't forget, often in some practices the billing can be done through one providers MSP number.  

A local derm colleague who does locum in alberta confirms this, that their billings are done through the clinic owner's #, and then takes the overhead cut from the billings. This is likely very much the case for the docs making >2million in public MSP billings.

 

42 minutes ago, offmychestplease said:

you're right but either way even if you don't make a single dollar in private, it's still possible to pull that in derm in AB

inttersting, since plastic sx, opthalmology, and derm are very lucrative, how do PD make sure that students are interested in subject matter rather than $$$?

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13 hours ago, JohnGrisham said:

Definitely, Derms get paid quite well in Ab. But don't forget, often in some practices the billing can be done through one providers MSP number.  

A local derm colleague who does locum in alberta confirms this, that their billings are done through the clinic owner's #, and then takes the overhead cut from the billings. This is likely very much the case for the docs making >2million in public MSP billings.

I agree. I know this is the case with certain high billers in Ontario. For logistical reasons you bill everything under one number (which is becoming increasingly frowned upon) and then the pot is divided up accordingly.

There are 100% physicians out there that bill 7 figures individually but I do not think that's something most medical students will be capable of doing for a variety of reasons. This is anecdotal evidence but none of my friends Derm, Opthal, and Plastics do that well. We are quite close as I help with their financial planning so I know their situation decently well.

You will do well in any of those fields but I really want to caution people against thinking that everyone goes off and prints millions a year. I'm not trying to downplay the income of physicians for selfish reasons but trying to provide a perspective of someone who is a staff and has friends and colleagues across the country. Most of all nothing good lasts forever and the health care system and its expenditure (aka our reimbursement) will be the target of future years to come.

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7 minutes ago, offmychestplease said:

The bold is a true statement BUT The fact of the matter is that it is possible to make the numbers I posted above for Optho(retina) in AB, derm in AB , and cosmetic plastics in Canada. No one was saying if most medical students could make those numbers but the question was how much do those 3 specialities make...and I provided the correct answer about the numbers. If you do retina in AB, derm in AB, or cosmetic plastics in Canada you will hit those numbers.

I think the original question was around why those fields were competitive. Money was one component that people raised. From that perspective I do believe it is important to convey the landscape rather than some case study on the theoretical max. That is as useful as saying FM is solid because you have the ability to earn 7-8 figures a year with weight loss clinics because Dr. Bernstein could do it. No doubt that there are many physicians in Alberta that are very successful however the majority of future physicians in Canada will not be practicing in Alberta. More importantly, I have my doubts about how long Alberta can sustain their billing schedule given recent provincial turmoil and economic issues.

My goal for this forum is to promote tempered information and advice for students. Some students will be wildly successful and while others will only be modestly successful. I think it's important to keep that in mind as your posts often give the impression that medicine is some sort of game that needs to be optimized. 

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4 hours ago, health&wellness&balance said:

 

inttersting, since plastic sx, opthalmology, and derm are very lucrative, how do PD make sure that students are interested in subject matter rather than $$$?

That's always a challenge as many students are very good at pretending they are interested even if they aren't that truly passionate. Perhaps that's not too bad of a reality as many students will still need to be enthusiastic, hard working, likable, and be a good culture fit. This is in combination with research and extracurriculars that take up substantial time and effort.

At the end of the day programs are looking for people they can work with for the next 5 years. If people are putting forth those characteristics on a constant basis it may be difficult to discern who is genuine and who isn't. However, it may not matter as you'll probably be a solid worker for the program if you demonstrate those other qualities for good or bad reasons. Also, it's important to know that PD and staff aren't perfect people either. Many are also aware of the compensation component of their field and aren't blind to that part of the equation.

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3 hours ago, health&wellness&balance said:

 

inttersting, since plastic sx, opthalmology, and derm are very lucrative, how do PD make sure that students are interested in subject matter rather than $$$?

Why would they care? As long as they are competent residents and do well for the field, I dont think they are concerned by motivations.

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3 hours ago, blah1234 said:

This is anecdotal evidence but none of my friends Derm, Opthal, and Plastics do that well. We are quite close as I help with their financial planning so I know their situation decently well.

If you're willing to share and out of curiosity, how much are they actually making (i.e., how much does it differ from perceptions of them being insanely rich)?

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29 minutes ago, gogogo said:

If you're willing to share and out of curiosity, how much are they actually making (i.e., how much does it differ from perceptions of them being insanely rich)?

Apologies, out of consideration for their privacy I wouldn't feel comfortable sharing even ballpark numbers. I will say they do well but not 7 figure well if that is at all helpful. There should be no worries about them starving or struggling if they are responsible with their money. Unfortunately, more MDs than I would like to see do live irresponsibly (sometimes paycheque to paycheque).

Numbers are also only part of the picture. There are considerations like practice location and mix that also play into professional satisfaction.

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