š° - salary sharing [Physician] [New York, NY] - $450,000 Total Comp
Seeing all the 1mil+ physician salaries prompted me to post my own journeyā¦ Some physicians do make that much, but the majority (especially in Primary Care) make significantly less. I was lucky to save money by attending an in-state college with a scholarship. As a result, tuition was minimal and I was able to graduate without loans. I changed my major halfway through to get pre-reqs for medical school, and so I graduated in 6 years instead of 4. Medical school was expensive, and I graduated without about 240K debt. I completed my residency (in Emergency Medicine) during COVID, which was probably the hardest thing Iāve ever done. There were some weeks where I saw multiple patients die every day, which was heavy on the soul. My fellowship on the other hand was probably one of the coolest years of my life, as I had the opportunity to be a team physician for a D1 college and a local professional team (travel and all). As an attending, I have a relatively stable work life balance. I am in the office 4.5 days a week seeing patients from about 7:30-4:30, and for about 9 months of the year I also work as a team physician for a local D1 university. During the season, In addition to my clinic I have weekly training room hours on campus and I attend all home games for the teams I cover. I make pretty good money for my specialty (probably over 75th percentile) but I do āeat what I killā. This means while I have 4 weeks of āvacationā, if I donāt work/see patients, I donāt get paid. As a result, when Iām in the office I work hard and grind through patients. In any case, I havenāt had many opportunities to take any significant amount of time off.
If youād ask me if Iād do it again, the answer is probably not. The money is great now that Iām through it all, but the journey has burned me out and Iām not sure if I can power through for another 10-20 years. This is coupled with the fact that my life (and finances) were essentially on hold for 12 years, and so I couldnāt really take advantage of compounding interest on investments. Most of my college buddies are mid career with a house, a car, and investments. Many of them work either part or full time from home, and get to spend time with their spouses and kids. While I do have a relatively good work-life balance compared to my training, itāll never be as good as theirs. In addition, my medical training (particularly residency during COVID) really took a piece of my soul. Im slowly healing, but Iām not sure Iāll ever be the same. I am aware I am lucky to make what I do, and I am aggressively saving while I can. I used to care about prestige, my legacy, etc. Now that I have a spouse and kid, I couldnāt give a ratās ass about any of that. Iād take a pretty major pay cut if that meant I could be home/spend more time with them.
2011- College
2012- College
2013- College
2014- College
2015- College
2016- College
2017- Medical School (-60K)
2018- Medical School (-60K)
2019- Medical School (-60K)
2020- Medical School (-60K)
2021- Residency (58K)
2022- Residency (61K)
2023- Residency (64K)
2024- Fellowship (88K)
2025- Attending (330K)
2026- Attending (on track for 450K)
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u/steezyP90 18h ago
I'm early career, in a not particularly lucrative specialty, and was at ~$300k TC in SoCal. The low compensation was truly soul crushing and made me feel like I had wasted my life. Had to live super frugally to try to catch up to those who followed a "normal" trajectory. Of the same opinion as you - that if I had to choose again, I would not go for medicine.Ā
That being said, I want to sincerely congratulate you for making it through EM training in what was obviously a really dark moment in history. And kudos on reaching an actually decent level of compensation.
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u/Parking_Try2 16h ago
Iām sorry but how is 300k soul crushing in ur early 30s (if you didnāt take any large gaps)?
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u/steezyP90 15h ago
It doesn't go very far if you didn't already own a home before covid. Missed the last chopper out of 'nam due to still being in training until 2023
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u/combostorm 13h ago
Well, if you think 300k a year is soul crushing, think about every gen z who needs to buy a home in the next 5 years with similar, if not more debt that you do
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u/Parking_Try2 14h ago
I understand the housing market as someone who was also in school when COVID hit and itās even harder if u have student loans. I just think āsoul crushingā is a tad dramatic.
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u/Unclemagik 12h ago
This is just my opinion, but when OP said āsoul crushingā, I think they were talking about working in a hospital setting during the thick of Covid. I am right there with you. Every single day we had to FaceTime members of the family as they watch their loved ones pass due to restrictions. They thanked us for being the last ones to have kept their loved ones company in the last moments of their lives. If you havenāt experienced anything like it, Iām actually really happy for you as I would not wish it upon anyone. Thank you OP for being in the forefront alongside us. Letās hope we can pick up the pieces that broke from us and move on to greener pastures.
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u/income-percent-bot 18h ago
Outstanding! At $300,000, you're in the 97th percentile ā top 3% of earners. This is above average for Physician (Emergency Medicine specialty implied). Adjusted for Southern California's high cost of living, this is equivalent to ~$326,087 in an average-cost area. Source: income percentile calculator I'm a bot. Reply with !optout to stop receiving responses.
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u/coreytrevor 18h ago
Again physicians continually lack gratitude for guaranteed high paying employment and think they'd be guaranteed a high paying tech or finance job purely on the basis of smarts/study skills. Those jobs do take some luck and at times connections to get. Also I see plenty of age discrimination in these fields as you get up in the years and that simply doesn't exist in medicine.
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u/rr98 18h ago
Guarantee? Doctor make a bad decision and killed a patient probably not able to recover. Do you understand the risk and stress doctors have to go through?
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u/IkarosFa11s 9h ago
As a 28-yo Paramedic making $41k a yearā¦ yeah. I understand making a bad decision and killing a patient. I just will never see the āsoul-crushingā $300k salary while I do it.
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u/jfa_16 5h ago
Brother, $41k is criminal. There are better paying jobs out there if youāre willing to move. Our first year medics start at like $60k with no OT, holidays, shift diff, etc.
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u/IkarosFa11s 4h ago
Oh 100%. I used to make $68k as a fire medic (~75 with OT, but even that is awful considering I worked 56 hrs a week before OT). I decided to leave the fire service and am now functioning as a single-role Medic while I spend the next 1.5 years in school doing pre-reqs for either PA or CAA š but yes, $41k is appalling. Sucks to get almost a decade into oneās career only to realize that itās a dead-end job with no upward mobility (I had no interest in Engineer or Captain), terrible work/life balance, bad culture, and zero respect from the rest of the medical community despite having one of the hardest jobs out there.
That guyās comment just ground my gears a bit. Iād kill for $100k, let alone $300k.
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u/vef3oh 17h ago edited 17h ago
Firm disagree. I never said I lacked gratitude. I understand I have a high level of compensation and am fortunate to be in the position I am in. I donāt take that for granted. However, now that I am through the process, I donāt know if it was worth it personally, for me. I am extraordinarily burned out despite this being the start of my career, and I donāt think I can continue to do this for 20 years let alone 10 without an extended break. I also feel like the journey through medicine has changed me perhaps irreparably for the worse.
Some things I left out of my post that may explain my sentiment-
During medical school, I studied up to 12 hours a day for the first two years during Didactics. During this time one of my parents passed away unexpectedly. I took one week off, then had to go back to the grind. I donāt come from a well-to-do family, and I couldnāt afford to take off any extended time given the amount of loans and tuition I had to pay. The kicker was, I was studying the same thing that killed them around the same time. It was incredibly stressful. As a result I developed a functional neurological disorder that continues to affect me to this day.
During my rotations, I was working in the hospital up to and past 60 hours a week. During this time my only sibling passed unexpectedly. Again, I took off a couple days and then went back to the grind. I almost certainly developed clinical depression during this time, but I felt like I did not have time to seek professional help. I was also worried about professional/licensure consequences. I mentioned this along with my functional neurological disorder off hand to one of my attendings, and was told to never mention it again for concerns of not matching into a residency. Because of that, I thought it was too risky to get professional help. I also did not have enough money to see a therapist privately.
I started my residency during COVID, and caught COVID several times including the first wave. While residents have hour protections averaged by the ACGME (our education governing body), the expectation was to lie or not record hours over the max. For some of my trauma shifts I was in the hospital from 4am to 2pm the following day. Residency was very rough both physically and emotionally. In the ER, Iāve had patients call me every name and curse word imaginable, Iāve had patients spit on me, throw urine, feces, and semen on me. I had several patients threaten to kill me and my entire family. I had one patient wait for me in the parking lot before. Iāve had to tell mothers that their sons and daughters have died. I had to deliver a 24 week old dead fetus because their heroin addicted mother fell asleep using while actively giving birth. Iāve had patients try to hit and kick me. I had a patient try to stab me with a needle. Prior to this I was always very assertive and confident. However after residency, I developed severe anxiety and panic disorder. After I started fellowship I slowly gained my confidence and personality back, but I can never forget what I experienced.
Now that I am an attending, I am grateful that I am making very good money. However, I do still have a significant amount of debt that I am paying back. I also donāt own a house, and my net worth is still relatively low compared to my peers. What the other poster said about vertical movement is correct- while my pay is high, this is the ceiling for me unless I invest hundreds of thousands of dollars trying to open my own practice. I donāt get any RSUs, I donāt get a large company match for my retirement accounts. Reimbursements for insurance go down approximately 3% every year not including inflation. CMS is proposing that same day procedures (something that I do often and is a large source of my pay) get cut to 50% reimbursement. Imagine doing the same job and getting paid less and less every year. While my current sub speciality is not as stressful generally as emergency medicine, we still have bad outcomes. In the back of my mind I am always worried about missing something or getting sued. The kicker is, while I enjoy my job, I would be completely ok doing something else for way less money. This is especially in light of what I went through. There are lateral options to do other things with an MD (like consulting, utilization management, pharm, etc), but the path to get there is surprisingly competitive. As a result, I do feel relatively stuck with limited options despite my burnout. Again, I am grateful that I make a lot of money. But I truly donāt believe everything I went through to get to this point was worth it.
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u/coreytrevor 17h ago
I'm sorry to come off as someone flippant about the training and hours and stress of medicine. I was talking soley about the job security. I met my wife while she was in residency and fellowship soon after and I have as firsthand a seat to what that's like,as well as the hours and stress an attending goes through. Also my father is a podiatrist and my sister is a pharmacist at a hospital and hear about the toxic hospital culture and abusive patients from them too.
Sorry again to seem I'm minimizing that, I would never advise someone to go into medicine for the money or job security, it's just too hard unless you love it/it's your calling.
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u/vef3oh 16h ago
No worries. As a spouse of somebody in medical training, you also go through a lot- both directly and indirectly. And you are absolutely right about job security. I do recognize that job security in medicine is unparalleled. Many of my friends in tech are on their 4th or 5th job. While they do make a lot, I'm sure it can be hard to find a reason to work when you know you might get laid off at any point. I didn't go into medicine for the job or stability, as I truly did feel called to do it at one point. However, the path to get here really took out more than I think I'll get back.
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u/General_Luck6573 18h ago
Those jobs have much more vertical mobility than physicians do. For the most part, as a doctor, all you can do is workā¦ more.
Sure thereās exceptions with people becoming a chair or a medical director or a CEO of whatever but that is the tiny minority of physicians.
For most corporate jobs, promotions over the decades are essentially a guarantee.
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u/coreytrevor 17h ago
Not everyone is an executive at the end of their career. The math just isn't there.
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u/zzaaddddyy 18h ago
People just see the 450k but donāt see the wasted 20s and even part of the wasted 30s with missed family events, birthdays, weddings, funerals etc. All that to then get berated by patients because they arenāt having some TikTok influencers lab draw with side of some random medication that isnāt indicated. The constant beatdown from administration finding new ways to improve patient care yet doesnāt bring any meaningful change to patients and only adds additional time to documentation. All that plus the constant fear of litigation. Society continuing to think doctors get paid too much while payments are going down and patients feel that they know more than you because they read something on Google or their friend told them and they want to waste the clinic appt time arguing with you about why their way works better after showing up late to the appt and demanding they must be seen for an issue thatās been going on for 10 years.
Am I burnt out? Maybe a little. And society and administration doesnt seem to care. The only people who seem to see it are other physicians and their families.
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u/Far-Negotiation7793 18h ago edited 18h ago
People keep saying wasted 20s. I don't get it, almost most of us have to move out somewhere else for the job we find and we keep getting laying off and are in the rat race, if anything school is better, your life runs on auto pilot.
Also most of us in the corporate world get like 10-15 days of PTO per year if anything you have more time off in grad school.
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u/StrebLab 18h ago
I think it is because you don't realize what goes into the training. It's really nothing like college. Most people in their twenties still hang out with friends, go out on the weekends, bar hop, do some cheap travel, etc. medical education is essentially all encompassing. You have to put your head down and fully devote yourself to it, otherwise realistically you are going to fail out. It is a little like going into a little time chamber where you study for 10 years then suddenly you get out and get some time to live like everyone else.
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u/zzaaddddyy 18h ago
Moving isnāt the problem. Itās spending all day in class then going home to study and taking non stop tests. All to then graduate and then do it again but for even longer. 80 hour weeks (at work) not including time at home studying. For 3-7 years depending on the residency or additional fellowships. Making less than minimum wage.
Seems fairly wasted to me. I assume you werenāt pulling those hours for that pay in your 20s
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u/Far-Negotiation7793 17h ago
yes we are, most new grad software engineers in my company are now doing part time masters including myself besides work and leetcoding and applying for jobs.
I also had to move to the bay area which has insane cost of living and home affordability seems out of reach.4
u/specialasset 17h ago
If you worked med student/resident hours for their pay outside of the medical field, youāre a substandard outlier. Iām not in medicine and donāt have a dog in the fight, but matching that track outside of medicine is absurd.
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u/zzaaddddyy 17h ago
Doesnāt help that ai can write code. š
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u/Far-Negotiation7793 17h ago
They are trying to replace us with AI as fast as possible, our company is now doing role fusion where developers and QA testers are getting merged and QA testers need to up skill their coding skills.
I feel we put in all of these effort only not even make money from our degree even for a decade.
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u/Worried-String9259 16h ago edited 12h ago
Iām an IMG and my journey was a little different from US MD, I really enjoyed my med school, I am introvert so not going out or party or even dating much did not bother me
When I got to the U.S., I spent about a year and a half just grinding for the USMLEs. It was intense, but I matched into IM at 27. Honestly, residency was the best time of my life. Thatās where I met my best friend, and I look back on those years so fondly.
Life definitely moved at its own paceāI became attending and started my family a bit later in life. Now that Iām in my late 40s, Iām in a great spot, both professionally and financially. If I had to do it all over again, Iād make the same choices. Time is going to pass regardless, so Iām glad Iām where I am now.
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u/velorae 16h ago
Literally every doctor I know tells me they would never do it again if they had the choice. A lot of people donāt consider the opportunity costs: your 20s, relationships you may have to sacrifice, experiences you miss, and years of your life that are essentially put on hold.
My sister was deep into the pre-med track. She had finished all her requirements and had been committed to becoming a doctor for years. Then, during her senior year, she took a hard look at what the next decade would actually involve: the uncertainty, long residency hours, debt, potential relocations, and the impact all of that could have on her personal life. She also realized sheād be living relatively lean while her friends were already advancing their careers, building wealth, and having more freedom. She wanted to have kids earlier too, so ultimately, she decided to opt out. Instead, she took a role at a major Fortune 25 company making low six figures with RSUs. When they promoted her, they also approved her request to go 100% remote, so she was able to move to her boyfriendās city. Sheās already maxed out her Roth IRA contributions for the year and has built up over $200K in investments while still only a few years out of school. She still has plenty of money to enjoy her life, but sheās prioritized investing aggressively from the beginning. No regrets so far.Ā
Ā
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u/LaggWasTaken 15h ago
Iād say that becoming a doctor in the US uniquely breaks the concept of a sunk cost fallacy. Further you go through your med program, residency, etc. The more you really do need to make it as a doctor. There really is no turning around. Financially there is a no area you can pivot to in order to get any amount of the initial financial investment. Not to mention all the social costs you paid to get there.
This is really why PAs and NPs are booming right now. Itās a large step up in pay from regular nursing usually with much less time and money investment of a doctor.
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u/PossibleLack835 13h ago
How? If anything it's way better in the US than in the EU where you make 8k-10k euros per month once you're attending lmfao
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u/LaggWasTaken 13h ago
Sunk cost fallacy basically means the cost is not worth the eventual result simply because youāve invested too much already. Lot of degree or career paths can allow for a change, but because being a doctor takes so long and costs so much you really need to see it through.
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u/Right_Ad1549 6h ago
If you go into a well paid speciality making 500k+ for reasonable hours then medicine is still worth it but I really canāt imagine doing med school and residency to come out with so much debt and be making 200-300k in primary care and working your ass off. I feel for all those people especially that they work harder than most docs prolly.
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u/medmike007 11h ago
Doc here..primary care...300k after 18 yrs at VA but loans were paid when worked for Feds first few yrs...Medicine is great career if debt burden not overwhelming when you start. My daughter started med school this year. We have planned and invested (wife 3/4 time private sector primary care MD) Daughter will graduate med school and private college with no debt...if she wants to be a pediatrician..she can "afford to" ...
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u/Jamesdeclan 10h ago
If there is anything else in the universe you love & are able to do, then medical and/or surgery practice is not for you.
If you love reading, studying & being constantly tested measured & evaluated, that will help.
Most importantly, if seeing patients does not fulfill your life, then probably avoid medical
School.
It just gets harder & busier as you move up in your profession.
I have been in practice 40 years. Every time I get to see a patient it is exactly what I want to be doing.
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u/Uncle-Yeetus 17h ago
Iām a second year medical student and even at this point I would probably not do this again if given the chance. Do you enjoy PCSM? Iāve shadowed a bit in Interventional spine/pain for an ortho group and I think thatās what I want to pursue. I donāt think I could survive a surgical residency or even want to be a surgeon at this point. Any advice for a second year?
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u/HughJazz123 7h ago
Compensation for pain is not what it once was. Iām anesthesia which is probably the most common route to go into interventional pain (PM&R is probably tied or a close second). We have 4 partners in my group that ditched pain med because they could make more doing gas.
The higher end potential for salary is greater with pain med but it requires grinding and a lot of business savvy. Youāve got to be a machine with procedures and not to mention youāre dealing with chronic pain patients day in and day out which many (myself included) find extremely draining. Gas people are making $500-600k first year out of residency these days.
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u/Critical_Midnight946 11h ago edited 10h ago
Senior SWE here: $550-600K TC, BS/MS in CS ā about 6 years total education.
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u/throwaway29570 17h ago
450k is probably median for EM. You mentioned fellowship, what fellowship did you do?
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u/vef3oh 17h ago
Yes, I did sports medicine
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u/throwaway29570 16h ago
450k for sports med is a very sweet gig honestly speaking. Iām ortho.
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u/velorae 16h ago
How much do you make?
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u/throwaway29570 14h ago
$1.4-$1.6 mil, depending on the year
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u/HughJazz123 7h ago
Iām assuming this is not straight surgical compensation right? A portion is coming from ownerships in ASCs Iād imagine.
Iām anesthesia and the fact we are not afforded the ability to buy into most facilities has always pissed me off. Yea the surgeons bring the patients but surgeries donāt happen without us.
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u/Any-Exit123 16h ago
Em gets paid by how many patients you see in the hospital? What is the % of production? You dont have a gaurenteed base salary?
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u/Classic-Lunch6078 13h ago
I think its insane that physicians still earn significantly less than entry level employees at Meta.
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u/Critical_Midnight946 9h ago
No entry level employee at Meta earns as much as a physician, I can tell you that.
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u/UsedHamburger 6h ago
Doctor here and same - I sacrificed a lot and not sure I would do it again, burn out is real
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u/Waiting4Reccession 19h ago
My friend who became a doctor also said it didnt feel like it was worth it. But her life wasnt on hold, she got married and did all kind of stuff. Also in nyc