Typically, when I reveal that I am a medical student, I receive one of the following responses:
- Great! You should go into ________ specialty because my _______ is really messed up and you should fix it.
- Great! You should give me some of your gobs of money because my money situation is messed up and you should fix it.
It has surprised me how often I will get a comment about the amount of money people think I will make. In the heat of the health care reform discussion, many people pointed to the greed of physicians and their exorbitant salaries.
Don’t get me wrong, I have met my share of doctors that proudly drive their Porsche or Ferrari, but I can assure you that that is far from the norm. However, my classmates and I have all been told over and over again that if we wanted to make money, there are much easier ways to do so. Our undergraduate advisors swiftly shuttled those students to other majors. Perhaps in the past medicine was a path one could choose if he/she was simply looking for a life of luxury. Assuming this was ever true, things have changed drastically (with very few exceptions).
As most know, insurance has completely changed the game. Compensation is not nearly what it was compared to the so called “glory days of medicine.” These glory days were when patients paid cash and doctors had more freedom are days that the older generation of physicians fondly remembers. To me and classmates, however, this seems like such a foreign concept that this mystical time rarely crosses our minds.
Instead, you will hear us griping about tuition and our ever rising mountain of loans. According to US Department of Education statistics, adjusted for inflation, the average cost of 4 years of college in 1980-1981 was $3,499. The average cost in 2008-2009 was $20,435 and has since risen considerably (http://blogs.chicagotribune.com/news_columnists_ezorn/2011/03/more-college-tuition-inflation.html). Below are some visuals:
This brings me to an article I read the other day (seen here: http://benbrownmd.wordpress.com/2010/06/20/informedconsent/). The idea behind the article is to add up lifetime net earnings. The author of this article used the following formula:
With this, he calculated the average hourly wage for an internal medicine physician ($34.46/hr), a high school teacher ($30.47/hr), a dentist ($61.91/hr), and a nurse ($24.43). The point he is trying to make (I must point out he is a physician and has some bias), is that physicians do not make much per hour adjusted over their lifetime. Comparatively, they make slightly more than the hourly rate of a high school teacher. Yearly salaries are higher than most professions, but the amount of debt physicians can accrue while in training is monstrous and increasing at an alarming rate. Here is a visual representation of this debt and the earnings of an internist from the article:
An interesting point I had not thought about before reading his article, is that physicians often end up in the higher tax brackets immediately after finishing and therefore lose a considerable amount of their income. Unlike other professions where income tends to steadily rise, young physicians are placed in the unique situation of being perhaps hundreds of thousands of dollars in debt yet heavily taxed. This leaves very little left over for even a well used Ferrari.
While the data presented in the article is very hard to estimate, I agree with most of the numbers he uses. I have found many people think that the educational cost estimates are high, but let me give you the average tuition costs. Last year, according to the Association of American Medical Colleges, the average private medical school cost was $45,986/yr, public schools were $26,845/yr resident, and $48,683 non-resident. According to finaid.gov, average undergraduate tuition last year was: $15,213/yr public in-state, $26,741/yr public out-of-state, and $35,636/yr private college. When one adds, books, fees, room and board, transportation, and interest on loans, it would not be difficult to find oneself hundreds of thousands of dollars in debt.
So how much do doctors really make? Sure, for many of them, the answer is a lot. This relatively small percentage seems to keep the stereotype alive. However, my classmates and I are not in this for money, because we know that times have changed. We expect that doctors will always be paid well, but are very aware of the length and cost of our training.
I don’t mean to say that doctors are poor or that people should pity residents. We are here because we made a choice to pursue what we love doing, and we are all confident we will be able to support ourselves and our families in the long run. On the other hand, many of us anticipate eating a lot of ramen noodles and continuing to drive our rusted Kia’s for the next decade or so.
I found the above article really interesting; let me know what you think about it. According to its data, maybe we should be looking to dentists to fix our money woes. Buying stock in ramen might not be such a bad idea either.
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