What do you do that you earn six figures?

[u/fidgit86]

It seems like a lot of people make a lot of money and it seems like I’m missing out on something. So those of you that do, whats your occupation that pays so well?

[u/MrMudPhud]

Yup. Doctors are financially illiterate, and because of that we get taken advantage of. "Oh, $300K/year to be an ICU doc? That's way better than $130K/year as a software engineer." Then, hospital administrators and med schools look at the situation and go, "So how far can we push these kids using salary as justification?" The answer is about 10 years of missed income and $400K in debt.

I have tried over the years, on many occasions, to explain opportunity cost to other med students/physicians. You can literally make all the sacrifices of a doctor through your mid-30s and come out ahead if you go into almost any other decently high paying field that doesn't require tons of post-graduate training. People on these forums see that easily. They understand how an extra ten years of compounding interest will dramatically change any investment portfolio, but if I make this point on a physician subreddit I get bombarded with downvotes and non-quantitative hunches. The only reason physicians are richer in real life is that almost no one takes advantage of their retirement savings while young. The wealth building opportunity is exactly the same. Engineers overwhelmingly choose a higher QOL than what med students have.

People here of course understand it. If I told you that basically any professional would spend the first 10 years of their career spending $25K and living like a med student/resident, you would all tell me that they would become rich. Most people don't get this. They just see salary.

A lot of the time it comes down to it just not mattering. Most doctors don't do it for the money and wind up fine. They get to spend on big purchases and that's what they really wanted. Then they enjoy a more modest retirement, and that's also fine.

Also, the number of doctors making >$500K/year is also pretty low. Increasingly doctors are employees. Like in any industry, there are some outliers, but the days of $500K+ are dwindling.

[u/AssaultOfTruth → u/MrMudPhud]

Great post. Moreover the average software engineer doesn’t work anywhere near as hard as a med student. There is also no chance of being $300k in debt almost finished it and...oh crap mental breakdown or health event precluding completion. There are people who are not doctors but have a lot of med school debt.

[u/Do_things_wrong → u/MrMudPhud]

​

man... I take the MCAT in a week. had some personal finance classes in undergrad though so hopefully something stuck.

[u/curiouspda12345 → u/Do_things_wrong]

Eh don't let this guy scare you that much. There are a lot of good reddits even a doc one (r/whitecoatinvestor) that provide basic tools on how to not fuck up and survive your middle years and old and can't have young people fun years.

[u/thenameinaz → u/Do_things_wrong]

+1 on white coat investor. TLDR: Basically live like you’re in residency and med school until you pay off your loans.

[u/WoodenYogurtcloset86 → u/Do_things_wrong]

Med school was fun (make friends), residency sucks even if you make friends. But, almost done with residency and things are looking better. I’m glad I did this rather than some tech job working for random x company. Even if you’re employed by random x hospital, you’re always helping a patient directly

[u/VascularOlive → u/Do_things_wrong]

Just tested on 7/30. Browsing through these threads. Hopefully living my entire life in poverty doesn’t make me want to let loose immediately after I get decent money.

[u/c00lAsAMoose → u/[deleted]]

If you don’t mind me asking, how old are you? I’m in the same boat but retaking the mcat in January and trying to figure out if I’m 100% in on medicine.

[u/coyotecantspell → u/MrMudPhud]

Specialty matters too

[u/Charming_Amphibian37 → u/MrMudPhud]

Yep, i count going to med school my biggest mistake in my life and convince friend’s children to study sth else. The overall pay is higher, but not enough to compansate this much effort.

[u/MrMudPhud → u/Charming_Amphibian37]

Absolutely. The grind/competition is absurd.

Working this hard while being even remotely intelligent in any other field will have you near the top in no time. My old CEO, a former bigwig at Merck, tried to recruit me to the business side of pharma. She basically said, "I'll write your letter, you'll get a job in research, transition to management, get your MBA part time, and head off to business development."

I'm really happy with medicine/research as a calling, but it's highly unsatisfying to be called average and essentially get lectured at by MBAs on how to be more useful. Definitely looking into doing the medical director track in pharma. Gotta score that name brand residency first.

[u/GrassNova → u/MrMudPhud]

Meh, I'm not sure if it's that simple. One of the upsides of being a doctor is it's basically a set path, you know almost exactly what you need to do to get ahead. In undergrad it's GPA, research, MCAT, and ECs. In med school it's about getting a good mark on your Step I/IIs, recs again, etc. You don't have to focus much effort on figuring out what you need to do, or waste a lot of time going in the wrong direction, but get to pour all that time and hard work on clear tasks and stepping stones.

Don't get me wrong this is all definitely difficult work, but it's not the same as other fields where there aren't very many tried and tested paths. Also being a doc and other career choices also often require different skillsets and even personalities that may not transfer over as easily as some people think.

[u/Iheartmypupper → u/MrMudPhud]

I got a buddy, he's been out of residency for about 3 years. he's clearing $260k/year in a low CoL area. By himself he's sitting at 5x the annual household income for the area. He gets his 401k match, and that's it. no other investing. doesn't max his 401k, doesn't do an IRA, nothing.

we're supposed to be having a talk about investing in the near future.

[u/MrMudPhud → u/Iheartmypupper]

It's shocking when I meet young attendings who clearly have no idea what to do financially. Rent expensive apartments. Spend their whole paycheck. Etc...

I did the MD/PhD route. It's the ultimate opportunity cost sacrifice. Still I put away ~$7-8k per year making a stipend and I'm closing in on $100k NW. If I am worth more than you making 1/10th your salary, you done fucked up.

[u/Eighty-Sixed → u/Iheartmypupper]

I am in my first attending job. My HR is surprised I am maxing out my 401k and note how proud they are of me (I am a woman in the south, I am used to pendants and being called honey, etc). Admittedly, I am playing catch up on life stuff (bought a house for 300k with 20% down, buying a car for 60k with 50% down, got married with no help from parents, reproducing) but I am almost done with student loan debt (less than 50k - I paid off over 100k during residency) at 2 years out. I do max a backdoor Roth for both of us, max my husband's 401k, contribute to HSA (but having a kid is expensive) and my husband puts 400 a month in Adobe stock (he works for them and gets it at 85%). I plan to put the tax deductible amount into a 529 account (8k) once my son is born. But then I know I need to start actually actively investing beyond the passive stuff. And for some reason it is scary to me to put it into stocks than to have it in my bank account, even though financially it makes no sense.

My husband never thought he would be in this situation and has no knowledge of things to do and wouldn't take advantage of any of it without my direction. While he makes decent money, his paychecks are small because of all of the deductions. I didn't play a huge role in his finances until we got married and now I manage all of the money. He is the first in his family to even go to college and his parents work blue collar jobs (one works at a fast food restaurant and the other assembly line) with eons of debt and no retirement savings or otherwise. I am the first doctor in my family from largely blue collar workers who rather tuck money under the mattress than trust any bank. So I am trying.

[u/Iheartmypupper → u/Eighty-Sixed]

for what it's worth, it sounds like you're killing it.

[u/flamingswordmademe → u/Eighty-Sixed]

What do you mean "invest beyond passive stuff"? If you're talking about actively managed mutual funds you definitely don't have to (and shouldn't) do that no matter what

[u/Eighty-Sixed → u/flamingswordmademe]

No, by passive I mean money comes out of my paycheck for my 401k and I put money into a backdoor Roth once yearly but I don't put money into investments otherwise. I guess the 401k is passive in my head because it is done for me by someone else. I meant I should be actively taking extra money every month and putting it somewhere beyond my savings account each month. I have around 3-4k extra every month (and will have more soon after I come off guaranteed salary). So far it has gone to a down payment on a house, building an emergency fund, and a car. But now that we aren't saving for anything specific, I need to do something with the extra money because the tiny bit of interest it accrues isn't cutting it.

[u/flamingswordmademe → u/Eighty-Sixed]

Gotcha. You're right it is more active in that way, but all you have to do is create a taxable account at an online brokerage and invest just like you do in your 401k and IRA. do automatic transfers and it'll be autopilot just like your retirement accounts

[u/2Confuse → u/MrMudPhud]

Yup. Hugely unpopular opinion to the masses, but we deserve to be paid more, ESPECIALLY in residency.

We have lesser “equivalents” in the work force essentially making double at half the hours. Wtf is up with that.

[u/Chapped_Assets → u/2Confuse]

Yea when I was a surgery resident I think we calculated it out to like $15 an hour or some shit.

[u/AeneasSonofAnchises → u/2Confuse]

“Lesser equivalents” smh……

And doctors complain that people thing they’re arrogant

[u/2Confuse → u/AeneasSonofAnchises]

This is in regard to people with only 500 hours of shadowing being paid more than MDs with ~6000 hours of real clinical experience and actually difficult board exams.

Residency is the hospital’s excuse to not pay MDs or DOs what they’re actually worth.

[u/Ppalgans → u/2Confuse]

Tbh I don’t think it should be “pay more” but “work less”. The amount of time most doctors work is absolutely ridiculous. How do you expect a human being to take care of another one, who is ill, if they’re tired out and lacking sleep? The whole system needs a change istg

[u/2Confuse → u/Ppalgans]

I am fine with either honestly. Medicine gets humane or medicine becomes fairly paid again for ALL specialties.

[u/bluepaintbrush → u/MrMudPhud]

This is for sure true of people who want to be doctors for the money. But the ones I know who toughed it out have a more intrinsic relationship with being a physician and knowing they can help people in that way. So they get more reward out of the role than an SWE for example.

[u/MrMudPhud → u/bluepaintbrush]

Absolutely. One of the best things about adopting a FIRE mindset is acknowledging that you can accomplish the same thing with different incomes. When you stop worrying about "more" and start worrying about "enough" you can honestly ask yourself if you'd rather do one career vs. another.

[u/italiabrain → u/MrMudPhud]

Yeah agree with this in general, but there are some of us who vaguely know what we’re doing. There are also some capital accumulation / tax arbitrage things you can do if you’re willing to bleed off $50k+/yr of lifestyle money that only make sense over a certain yearly income (effective tax rate).

I broke $100k my second year of residency with ER moonlighting. It wasn’t close to the highest paying place, but it was worth it with malpractice completely covered and willingness to schedule around whatever rotation I was on.

I also stopped at a 3yr IM program to do night hospital work. I get to do a fair amount of open ICU, my own bedside procedures, and I make more than some of my classmates who went through another 3yrs for Pulm fellowship. I do work some extra shifts, but my lowest year has been $420 and I actually prefer nights anyway.

The people who are really getting screwed are the people who are actually underpaid on top of the debt. Our in-hospital PharmDs work a similar 7-on 7-off to our hospital docs but make 1/3 the hourly, no productivity, no bonuses. They actually need the PharmD and the ones I work with also did a 2yr inpatient/emergency pharmacy residency.

Then there are the degrees that never should have been made doctorates. You don’t need a doctorate as has been normalized for PT or upcoming OT. It’s crazy how fast it advanced too. Lots of managers of current departments who graduated 15 years ago are doing the job fine with a bachelors.

[u/deathnow098 → u/MrMudPhud]

It depends on doctor's salaries really... if you're right that there is no difference between them and software engineers salaries, it's obviously insane.

When I google the salaries, tho, software engineers make like $280k at the top and MDs, esp surgeons, seem to make $400-$800k. If those are real numbers, you can run an interest calculator even if the software engineer was living pretty frugally for 10 years (and their whole career), they wouldn't ultimately make as much as the doctors, although it would be way closer than most people think probably, yeah.

If MDs are only making $300k, then they're obviously much worse off, tho.

[u/MrMudPhud → u/deathnow098]

I've done the math. Basically if you have the engineer living as frugally as the physician until they're done residency, then you have the physician live as frugally as the engineer thereafter (so equivalent lifestyles) the engineer comes out ahead of PCPs at ~$130k average income. For specialists it's much harder for the engineer to overtake. It's more like $200k, which is tough to average even at FAANG.

For anything other than finance, it's basically impossible to beat a rural orthopod. You'd be making close to seven figures in like... Nebraska.

This all assumes they work until 65 though. Personally I think the chances of physicians making this kind of money until 65 these days are slim to none. If I still need the money, which I probably won't given I invest properly and don't experience massive lifestyle creep, I would have to consider a mid-career switch to Medical Director positions in pharma/biotech.

[u/underengineered → u/MrMudPhud]

I've had this discussion with friends. MD vs Mechanical Engineer in the building industry.

The engineering degree is done in 4 years. You're 22 with minimal debt making $50k/yr. Bybthe time the future MD graduates medical school the mech engineer gets their PE. I hit 6 figures in year 6.

By the time the MD graduates medical school and gets out of residency they have 6 figures of debt and a lost opportunity cost of around $750k vs the engineer. If the MD wants a really big salary then they'll take more time to specialize.

Their salary will eventually overcome the typical engineer but not before they are in their 40s. And if you go into family practice or pediatrics you may never catch up.