Did You Go Into Medicine For The Money

[older]

European med school and North american med school are set up completely differently (6 vs 4 years for one thing) so you can't really use direct entry in Europe as evidence of superior secondary education.

 

They are set differently for a reason, one of them being that North American secondary education system was not considered good enough to be sufficient for med school.

[older]

You should read the stars can article I posted. Success of kids in private school is due to socioeconomic factors, not because they go to private school. Put those kids in public school and they are still set up to succeed. That also doesn't cover the fact that some private schools only admit kids likely to succeed (admissions exams etc). The private school kids do better because they are the kids more likely to succeed from the start, not because they are in private schools.

 

Can you post a link to the article? Thanks.

 

Socioeconomics factors count heavily, one of those factors being able to afford private school.  But do not kid yourself that public schools provide, on average, the same learning environment and equal challenges. You give a good example with private schools admitting kids likely to succeed (admissions exams etc) - the goal is to to maintain  high standards. But most of private schools recruit at JK level, with no exams whatsover.  Only if you try to join later, say in grade 7 or 9, you have to take  exams becuse, after several years, the gap between public education and private education widens considerably. And rich kids fail these admission exams despite their socioeconomic advantage.  

[ralk]

Doesn't this tell you something? Universities have to teach material from last year of school  because most of the kids did not master it at school, public or private. Repeat for you, a new thing for many others. Lots of under-prepared kids go to university and then drop out. Not to mention that elsewhere in the world this material is taught in grade 9 or 10.

 

You are right, some private schools are not strong in academics, and some public schools are relatively good.That doesn't change my point -  I commented on average level of secondary education in Ontario, as well as on wide inconsistencies  in programs, teaching and assessment. it is below standards of developed countries. Only IB program can be compared to world standards, and  it is way more advanced than Ontario curriculum.

 

I went to one of the least academic high schools in my city, and still came away with fairly good preparation for university. The curriculum for the major, important stuff is basically the same at each school. The bells and whistles change school-to-school, which is what private schools and the more academically-focus public schools, but those extras aren't that critical and can be made up in other ways.

 

There are certainly flaws in our public education system, and our education system in general, but your assertions don't seem to be supported by the data. The major sets of data I could find on Canadian education put us above most of the developed world, not behind it, with a lower spread of results between the top and bottom performers. Private education on the whole is no better than public education once accounting for socioeconomic status - it's not just that some outlier public schools are better than some private schools,

[older]

While grade inflation is a huge issue in Ontario schools - the level of education available is actually pretty fantastic.  There are no large private high schools in London, ON (the few that exist cater mostly to international kids from China/Korea).  Yet there are tons of very successful kids from London (whose parents are usually professors or MDs or dentists or lawyers).  The MDs, Laywers, Dentists all send their kids to local high schools that are public (though many do send their kids to private school - Matthews Hall - up till grade 8).

 

The public high school I went to had incredible resources that would compare favourably with the best private schools - and the success of their students is the proof (look up London Central).  But even the average high schools in London still offer fantastic programs.  The HSs that do the best are those that are in the wealthier areas.  Socioeconomic status is the difference - not the quality of the schools.  You really need to get you head out of your arse with asinine snobby statements like yours.

 

 

Kudos to schools in London Ontario. Seriously, they may be on the top end of generally miserable Ontario secondary educational system. Inconsistency is its most damning attribute.

[older]

I went to one of the least academic high schools in my city, and still came away with fairly good preparation for university. The curriculum for the major, important stuff is basically the same at each school. The bells and whistles change school-to-school, which is what private schools and the more academically-focus public schools, but those extras aren't that critical and can be made up in other ways.

 

There are certainly flaws in our public education system, and our education system in general, but your assertions don't seem to be supported by the data. The major sets of data I could find on Canadian education put us above most of the developed world, not behind it, with a lower spread of results between the top and bottom performers. Private education on the whole is no better than public education once accounting for socioeconomic status - it's not just that some outlier public schools are better than some private schools,

 

The major set of data (OECD) puts Canada (not Ontario) in good 13th postion, but certainly not "above most of the developed world".

 

Have no data to support or refute your statement "Private education on the whole is no better than public education", do you?

[ralk]

The major set of data (OECD) puts Canada (not Ontario) in good 13th postion, but certainly not "above most of the developed world".

 

Have no data to support or refute your statement "Private education on the whole is no better than public education", do you?

 

http://cdn.theatlantic.com/assets/media/img/posts/pisa-2012-results-overview%20graph%201_larger.jpg - yeah, we're behind Japan, Finland, the Netherlands, and a few others, but well ahead of the major English-speaking and European countries. No G7 country is ahead of us besides Japan. We're above the average and most of the obvious comparative countries. I'll stand by my statement that we're ahead of most of the developed world.

 

http://www.cbc.ca/ne...-says-1.3016123

[older]

 

So you can play games with this sort of stuff - private schooling for 12 years OR fully (I mean fully) funded university education AND a paid off house worth roughly 500K given to them when the graduate (or ok 500K equity in a house as an alternative). Dealers choice.

 

Great math! Thank you.

 

And where are the retirement savings the whole discussion started with? Can we still afford it?

[MathToMed]

Doesn't this tell you something? Universities have to teach material from last year of school  because most of the kids did not master it at school, public or private. Repeat for you, a new thing for many others. Lots of under-prepared kids go to university and then drop out. Not to mention that elsewhere in the world this material is taught in grade 9 or 10.

 

You are right, some private schools are not strong in academics, and some public schools are relatively good.That doesn't change my point -  I commented on average level of secondary education in Ontario, as well as on wide inconsistencies  in programs, teaching and assessment. it is below standards of developed countries. Only IB program can be compared to world standards, and  it is way more advanced than Ontario curriculum.

 

I agree that we have severe problems in our education here. From my perspective (as a math/science teacher) I've seen a lot of dumbing down of the mathematics curriculum to the point that universities have had to slide back and teach more highschool curriculum...however I'd like to point out two things:

 

First, the IB program is not that much more advanced than our curriculum. The so called High Level courses certainly are, but in reality a small percentage of students (internationally) actually take that, the majority take Standard Level. Standard Level doesn't go into that much more depth than our courses with regards to most subjects. Math for instance, we stop just before Integration, but SL does that for about a month or two.

 

However most people going to SL wind up forgetting that stuff anyway, anecdotally, and need to be re-taught. The real advantage of IB is its consistency - the breadth and depth of certain courses depends entirely on the teacher in this system. Frankly (having a masters in math) I'd likely teach calculus exactly like the IB class anyway, with the exception of integration as that's not in the curriculum, so my hands would be tied. I'd hold my kids to a high standard, work damn hard to get them there, and expect them to work hard or be left behind. Unfortunately, many teachers don't share that mindset.

 

So are there problems with our curriculum? Certainly, it's getting dumbed down annually. Seriously, I encourage everyone to drop into their old high school and stop into their favourite (science/math) class...you'll probably notice the way it's taught has changed.

 

The thing I wish to express is that IB isn't actually so great either, by comparison.

 

-----------------

 

The second thing I want to talk about is reviewing content in first year. This happens almost everywhere, any time schools amalgamate, due to a lack of standardization as I mentioned above. Whether it's here or in another country, teachers will always review content in the first year of middle school (if it exists), high school, university, college, etc. It's to bring everyone up to speed and make sure there's a level playing field. By second semester, the standard is typically raised a lot.

 

The notable exception to this are the very high population countries (Japan, India, China, etc.) because things are just so competitive due to sheer volume, that they can afford people failing out. And people work their asses off to avoid failing out as that's the expectation. However I don't think this is a pro/con of the education system itself, and is more a societal norm in those places. Those countries typically produce people who work hard, while we produce people who are entitled...however they very rarely produce creative people (for better or for worse). Would you then say, their schooling is superior or inferior? At lower levels we're outperformed like crazy (indeed, for international math day some of my students went head-to-head against China, grade 10s, were obliterated by Chinese grade 3s...except for the kid in my class who came from China, who dominated everyone), but at higher levels we gain significant grounds.

 

It's hard not to go off on our education system (as I certainly see countless flaws with it), but you really have to think about what you're criticizing. This first year review for example, might seem like a waste of time...but tell that to those poor guys in India who happen to fail out and become shunned for the rest of their life. I bet they'd turn around and say our system was better.

[MathToMed]

Great math! Thank you.

 

And where are the retirement savings the whole discussion started with? Can we still afford it?

 

The way this particular site works, I had to break it into two calculations - one with annual 20K contributions, and one where the money just sat there for 4 years during undergrad. The first link does the first calculation, the result is then fed into the second link, which provides the final running total after 16 years:

 

For the 12 years of private school

 

http://www.calculator.net/annuity-calculator.html?cstartingprinciple=0&cannualaddition=20000&cmonthlyaddition=0&cadditionat1=beginning&cinterestrate=6&cyears=12&printit=0&x=75&y=13

 

For the following 4 years of undergrad

 

http://www.calculator.net/annuity-calculator.html?cstartingprinciple=357643&cannualaddition=0&cmonthlyaddition=0&cadditionat1=beginning&cinterestrate=6&cyears=4&printit=0&x=83&y=9

 

End Balance

$451,516.05

 

Note: I haven't deducted tuition fees from that account as I'm only talking about the contributions based on the private school tuiton - if it sits there in the bank until they're out of university, there's a pretty penny. I've also assumed a 6% interest rate, which is quite modest. If you'd prefer, deduct whatever tuition you feel is reasonable from that total. You should also consider that tax hasn't been factored in.

 

Regardless...these numbers are staggering. This is per child as well.

 

EDIT: If I up the interest rate to 8% (which is pretty reasonable as well):

 

End Balance

$517,496.88

[rmorelan]

The way this particular site works, I had to break it into two calculations - one with annual 20K contributions, and one where the money just sat there for 4 years during undergrad. The first link does the first calculation, the result is then fed into the second link, which provides the final running total after 16 years:For the 12 years of private school

 

http://www.calculator.net/annuity-calculator.html?cstartingprinciple=0&cannualaddition=20000&cmonthlyaddition=0&cadditionat1=beginning&cinterestrate=6&cyears=12&printit=0&x=75&y=13For the following 4 years of undergradhttp://www.calculator.net/annuity-calculator.html?cstartingprinciple=357643&cannualaddition=0&cmonthlyaddition=0&cadditionat1=beginning&cinterestrate=6&cyears=4&printit=0&x=83&y=9

 

End Balance

$451,516.05

 

Note: I haven't deducted tuition fees from that account as I'm only talking about the contributions based on the private school tuiton - if it sits there in the bank until they're out of university, there's a pretty penny. I've also assumed a 6% interest rate, which is quite modest. If you'd prefer, deduct whatever tuition you feel is reasonable from that total. You should also consider that tax hasn't been factored in.

Regardless...these numbers are staggering. This is per child as well.

 

EDIT: If I up the interest rate to 8% (which is pretty reasonable as well):

 

End Balance

$517,496.88

Awesome - the math is basically the same as mine with same assumptions ( two math people thinking alike) - my example had all 4 kids the OP mentioned were running around.

 

To be fair in hindsight you probably get a discount for sending all four at once. Meh the Mathis still too powerful to ignore and I would just scale the investment amount the same.

[rmorelan]

Great math! Thank you.

 

And where are the retirement savings the whole discussion started with? Can we still afford it?

Well let's say we don't hand the kids a house - I actually don't believe in doing that. If you don't learn how to earn and invest then you have no power . Eventually the kids or your grandkids (the grand kids I guess of the stock broker) don't know what they are doing and the family suffers. The key is the knowledge not the cash. Getting rich is work and time and knowlege. Staying rich is similar.

 

If you don't and the same tuition is left as per the example and you start having kids at age 30 so the last one grads when you are 58 let the roughly 4million in the company grow for say 7+ more years and thus at say double you will have 8million or about 5.2 million is today's money. And that assumes you even stop investing 53 which is stupid because you income is at its peak and the your expenses are least. Want to add another 2 million well just keep going - mortgage is already paid off even so why not? Retire early? Sure why not. Go part time and you have the I stopped at 58 model. enjoy your statistically speaking 25+ years of retirement.

 

That would give as an annuity As an example of about 230K a year indexed for inflation for life. 230k when you house/cottage and kids are all paid for? That is worst case. Doing nothing fancy there.

 

Other things - no spouse income factored in (so more). Plus I assumed low savings when you start (5 years to save for house and tackle loans etc - not trying to kill anyone here). There still is a government top up with a bit (two people 20k at least).

 

And importantly all of this is pretty low key - minimal work, no real investing knowledge, just basics, basics, basics. You don't become obsessed with money. It doesn't rule you - you rule it.

[PilotMD]

To answer the original question

 

Now 6 years into residency (14 years total training) and still facing another two - three years of training before I finally 'start' my career, I can say quite confidently that the answer is no.

 

You could argue that our job is important (dealing with life and death), difficult (stressful surgery, complex patients, etc), stressful, yada yada yada. Yet I'm sure anyone could state a job that is also one, if not all of those things. The reasons I feel we are paid the 'big money' is the length of training it takes to do our job. I struggle to think of careers that demand 10 (family practice) to 13+ years (surgical specialties) of time and effort before you can even begin your career. During this time, you are, for the most part, going into more and more debt. Then, as a resident, you are making what amounts to minimum wage (or less) depending on the hours you work. I find it very interesting to see the looks on new medical students faces when I tell them how many years of training I've completed, and yet, at the end of my residency and functioning essentially as a junior staff member, I'm still making less money than most of the nurses on the ward!

 

Of course money is not the reason to go into medicine - its simply not worth it. There are other careers where you could make very good money in a quarter of the training time. You really do need to love the work - and most of us do. But I could love other things as well - I don't 'need' to be a doctor; I am because I enjoy it. I'm not overpaid - I will apologize to no one when I'm making over half a million a year - if you want to as well, then feel free to invest 17 years into post secondary education like I will have to do it. We are, I feel, not compensated well for the job we deliver at the end (though that still warrants a good pay check), but the time and effort needed to train to do the job (you will hear how medicine robs you of your 20's and early 30's  - this is not untrue, and just happens to be some of the best years of your life). 

 

You may also find it interesting, like I do, that the ones who tend to complain the most have no problem buying $500 dollar tickets to an NHL game to support a 20 year old making 5 million a year to play a sport. 

 

Cheers

 

PMD

[rmorelan]

Awesome - the math is basically the same as mine with same assumptions ( two math people thinking alike) - my example had all 4 kids the OP mentioned were running around.

 

To be fair in hindsight you probably get a discount for sending all four at once. Meh the Mathis still too powerful to ignore and I would just scale the investment amount the same.

not to beat this topic to death but one other thing about private schools - it isn't just the tuition that is expensive. There are supplies, trips, and generally keeping up with the Jones effect there as well. You have to factor all that in as well.

[NLengr]

 

You may also find it interesting, like I do, that the ones who tend to complain the most have no problem buying $500 dollar tickets to an NHL game to support a 20 year old making 5 million a year to play a sport. 

My wife has two guys in the extended family who play in the NHL. One earns 4.5 million a year currently (on contract for another couple of years). The other earns 1.3 million a year (unrestricted free agent next year). 

 

I really shoulda worked harder at hockey.

[NLengr]

Can you post a link to the article? Thanks.

 

Socioeconomics factors count heavily, one of those factors being able to afford private school.  But do not kid yourself that public schools provide, on average, the same learning environment and equal challenges. You give a good example with private schools admitting kids likely to succeed (admissions exams etc) - the goal is to to maintain  high standards. But most of private schools recruit at JK level, with no exams whatsover.  Only if you try to join later, say in grade 7 or 9, you have to take  exams becuse, after several years, the gap between public education and private education widens considerably. And rich kids fail these admission exams despite their socioeconomic advantage.  

I already did. It's even got the stats can report linked in it.

[NLengr]

They are set differently for a reason, one of them being that North American secondary education system was not considered good enough to be sufficient for med school.

Can you provide any actual evidence of this?

[makingfetchhappen]

Last time I checked, I wasn't being forced to give half of my earnings to the NHL. 

It's pretty rich for someone to claim that the government under pays them at half a million dollars a year. That's more than our Prime Minister makes. Even the President of the U.S. makes less than that...

And no one gets to be leading a country in 17 years (questionable number too, I'm not sure why your undergrad is included. Sure it's required, but so is high school, why not just start counting at grade one?).

[NLengr]

It's pretty rich for someone to claim that the government under pays them at half a million dollars a year. That's more than our Prime Minister makes. Even the President of the U.S. makes less than that...

 

Yeah, but the salary as president/prime minister isn't when those guys make their money. It's afterwards when they are commanding huge amounts of money for speeches, being involved in industry etc.

 

Bill Clinton earned $105 million in speaking fees between 2001 and 2013.

 

Jean Chretien has a 30k speaking fee per engagement.

 

That's just speaking fees. Former politicians can command high prices lobbying and consulting too.

 

It's not as simple as the government is paying them 500k. The government is paying a contractor/business 500k for a service. The doc isn't seeing 500k. Plus, a lot of the time the cost per service rendered (say a colonoscopy) is pretty low. But the doc is doing a ton of them, so it adds up.

[makingfetchhappen]

Sure but it's not like surgical type specialties would be better off without public funding either by public insurance or private insurance.

Ordinary people don't have tens of thousands to cough up for surgeries and other expensive procedures (where I realize a huge amount goes to overhead). So you would end up with the absurd result that you would need to turn down a lot of people, and even a lot of the people who came up with the money would lose their homes and things like that. It would add more stress to the job, not less.

Conversely, family docs probably would not have a problem. OHIP pays like $30 per consult right? You could easily charge double that, and then waive the fee for 20-30% of patients who cannot pay. 

Most ordinary people cannot cough up $500 for Leafs tickets. They can however find a few hundred dollars for needed services. 

Just because the free market comes up with some strange results, doesn't mean that's how we should decide on our government expenditures. 

Btw, you know that part of the reason Leafs tickets are able to cost so much is how they are used between business people right?

Edited to add: Karl Lagerfeld's cat, Choupette, earned 2 million pounds last year for doing 2 modelling gigs. The world doesn't make sense. It doesn't have anything to do with physician pay though!

[PilotMD]

MFH, 

 

  As I'm not particularly interested in getting into a verbal jousting match with a complete stranger on some forum, I will respond only as such. 

 

I too, find it 'rich' that someone would post such a snide reply based on completely false information. In the future, please ensure you read, and correctly interpret someones comments before you feel the need to bash said person. At no point did I say that I felt I was underpaid, though you incorrectly deduced that I must since there is no other possibility if one feels they are not overpaid. But wait,  my statement was that I will not apologize for the money I will be paid as a staff surgeon. And I won't. I, in fact, feel that physicians are fairly compensated (hmmm, there is another possibility after all) for the length of training they complete and the service they provide. We are not overpaid, but I certainly don't think we are underpaid either. I won't be picketing the lines to demand more fair wages, that's for sure (though some physicians certainly would if they could). I am quite content with my future salary - it will be more than enough to feed my wife and boys. 

 

Thank-you for your insightful comments

 

PMD

[makingfetchhappen]

You wrote that you felt that you were not compensated well for the job you deliver at the end. I apologize if I centered in on one part of your post unfairly. 

Your comments regarding nurses and minimum wage pulled my interpretation of your message in a certain direction. But I didn't make up anything false or "incorrectly deduce" lol. 

 

Quote:

"We are, I feel, not compensated well for the job we deliver at the end (though that still warrants a good pay check), but the time and effort needed to train to do the job (you will hear how medicine robs you of your 20's and early 30's  - this is not untrue, and just happens to be some of the best years of your life)."

 

[aaronjw]

How the hell did we end up talking about hockey and those bastard leafs?

[PilotMD]

MFH, 

 

  Read the sentence you posted carefully (perhaps I could have worded it better)...

 

"We are, I feel, not compensated well for the job we deliver at the end (i.e. - we don't make big money because the day to day job of being a physician is any more important than any other job), .....BUT...... the time and effort need to train to do the job."

 

Aka - we are compensated well for the length of training it takes to become a physician, NOT for the job we deliver at the end of the training.

 

Furthermore, my comments on nursing salary and minimum wage were to highlight the aforementioned point of that paragraph that during this long training period, you are for the most part going more and more into debt and being relatively poorly compensated, particularly given the length of training you have acquired to get to that point. This income, however, is quite different than the income you make at as staff (two different points entirely).

 

Sorry if the sentence you posted wasn't clear.

 

Cheers

[makingfetchhappen]

Ha! 

Yup, this explanation makes sense. In this case, my comment was snide and I apologize.  

[older]

 

You really need to get you head out of your arse with asinine snobby statements like yours.

 

Here, a remark from a person who credits himself/herself with excellent education.  Very becoming to a future doctor indeed.

 

I second PilotMD in the request that  we read and objectively  interpret someones comments,  reply on merit and avoid bashing and snide remarks. Maybe culture of discussion is not taught at school, but it is expected and appreciated.