Doctors and their Income

[china]

My brother in law is a consultant - oncologist at a major hospital. Having stayed with him for a number of years while he was a student, I'd like to disagree with your statement that it is possible for a person studying medicine to join the top 1% of income earners quickly!!!

Here is a little bit of his story.

Coming from Chinese, Malaysian background, my brother in law's parents (ie my in laws) have sacrificed so much for him to study medicine. There was a period of time whilst I was working in Malaysia with my wife and we both stayed with my in laws. The stress they went through exchanging RM (Malaysian Ringgit) to AUD (Australian Dollars) to pay for his fees was incredible. Every day they watched the exchange rate and a minor change with the AUD becoming higher by a few cents was a major event.

Each year they faithfully paid his fees which were equivalent to what my father in law was earning in Malaysia at that time.

My wife and I then moved back to Australia and lived with my brother in law while he was studying. Studying until 3 am was not uncommon for my brother in law. In his first years of working he worked in an appalling hospital which shall remain nameless. 16 hr shifts were common. Any thoughts about money were completely irrelevant to him. He came home, went to sleep and then woke up to go to work again - repeating the whole 16 hour experience over and over again.

The exams and study required for him to reach consultant status were incredibly difficult and draining. He was studying at the same time as he was working.

He is now 39 and a consultant. He begins work at about 8.00 am and works well into the evening after he returns from the hospital at 6.30pm.

It has taken him the best part of 20 years to reach this level and his income is no where near 7 figures!!!

Money is not my brother in law's aim. He is a kind person and wants to help people. His job takes its toll on him and when his patients pass away he does it tough.

He will marry next year - no doubt his studies have also made it difficult for him to meet a spouse and have a family of his own......

His circumstances are a little different and atypical. But you are pretty spot on in your observations.

Firstly as an overseas student, he would have found it a little harder to ascend the ladder to becoming a consultant. Many medical graduates have reached consultant status by age 30. You graduate from medical school aged 23 and if you ascend smoothly through the ranks, you will be a specialist in any field by 30.

Secondly, the speciality he has chosen is one of the lowest earning of all the specialities. So he is unlikely to be part of the 1% of income earners within medicine, ever.

Thirdly, as a purely hospital employed specialist, his earning potential is capped. Essentially, he is a government employee and his total package only comes to about 300k which means he gets to take home about 150k per year or less. However, it is not all about money and he must have chosen his field due to professional interest.

For maximal earning potential within medicine, I would advise the ROAD specialities. (R) radiology, (o) orthopaedics, opthalmology, (A)anesthetics and (D) dermatology. If these don't appeal consider plastic surgery and obstetrics/gynecology.

 

[DaveM]

 

[geoffw]

I think China has a classic case of what Dr Freud would call doctor envy.

The topic has been done to death.

I'm closing this thread tomorrow.

Closing arguments please.

Because after this the topic will no longer be allowed.

 

[Ed Barton]

A specialist doesn't just qualify and instantly enter private practice earning a fortune. There are many years of building their 'business'; convincing referring GPs of their skill. There's the high cost of running consulting rooms that they may only use part time, high cost PI etc.

A reputable specialist will also do some work in teaching (IE lower paying public) hospitals. They will also be involved in non paying work like conference's, PD and research.

A reputable specialist in private practice will receive a large number of calls from GPs asking for advice that they can't bill for.

China - what experience do you have with medicine? IIRC in another thread a few months back you said one could negotiate specialists down to the medicare rebate rate? I suspect your experience of medicine is gleaned from relatives working in the US?

 

[china]

Just like to add my 2 cents worth

Have a couple of friends who have just graduated from medical school, and are doing their first years in hospitals.

Some comments I have heard are:

1) Hour for hour (rostered shift and overtime), the fast-food employee earns more than them in the year.
2) They do not look forward to repaying their massive HECS fees debts.
3) There are also constant assessments for them to undergo - part of staying qualified or updated in their medical training I assume.

I think China needs to understand that not everyone in this world is suited to be a medical doctor, no matter their motivation (helping others, money). Also, not all medical doctors become specialists - it takes many more years of learning and dedicated work, not to mention enough patients to fulfil the specialist's work.

===

With that said, I'd rather be a fast-food employee. No 6-year degree (and associated exam stress + debts). Free meals in the shift. Earns more than a medical doctor per year (rostered and overtime hours included).

By the time the medical student graduates, the fast-food employee would have already started feathering their retirement nest egg.

Sure the first few years working in the hospital are not the best years - only six figures a year for a lot of hours. However, the pay off is when they become a specialist. That is the time, when within a year or two, their fast food colleagues are left far behind financially. And you can be working as a specialist for over 30 years increasing your fees both to inflation and to what you believe you are worth.

There are not many fast food employees who can sell burgers for 30 plus years. They will remove you because you are becoming too expensive and will rapidly replace you with a keen 15 year old.

About one third of doctors are specialists and you are correct. Not everyone gets there but then again, most people are not in the top 1% of earners.

My consistent point in this thread, is that there will be many who are suited and my advice to young people seeking high income with fantastic job security to consider getting a medical degree. Ignore the naysayers who can't see beyond the few years at uni and who say it must be all too difficult.

Unless you have a severe aversion to lots of cash, it is hard to go past a medical degree for financial security and stability. It will give you the best chance to join the top 1% of income and wealth.

 

[china]

A specialist doesn't just qualify and instantly enter private practice earning a fortune. There are many years of building their 'business'; convincing referring GPs of their skill. There's the high cost of running consulting rooms that they may only use part time, high cost PI etc.

A reputable specialist will also do some work in teaching (IE lower paying public) hospitals. They will also be involved in non paying work like conference's, PD and research.

A reputable specialist in private practice will receive a large number of calls from GPs asking for advice that they can't bill for.

Agreed, but despite all these costs and non-billable activities, most procedural specialists will rapidly achieve a take home pay in the range of high six figures to seven figures.

Not many self employed businesses and solo practitioners in other professions can do the same with so much regularity.

 

[china]

I think China has a classic case of what Dr Freud would call doctor envy.

The topic has been done to death.

I'm closing this thread tomorrow.

Closing arguments please.

In all the brouhaha, I have only ever sought to make one point. Please consider a medical degree if searching for financial security and the highest likelihood of consistently being in the top 1% of income earners. It is not too difficult and should not be dismissed as a fantastical idea.

 

[geoffw]

Unless you have a severe aversion to lots of cash, it is hard to go past a medical degree for financial security and stability. It will give you the best chance to join the top 1% of income and wealth.

My point previously is that income and wealth are not the same thing.

Income is the money you get on an ongoing basis. Wealth is what you accumulate by careful management of your income and investment. If your lifestyle expenses exceed your income, no matter how high or low the income, you will never accumulate wealth.

Most people here are focused on wealth, and many have succeeded in accumulating enough for a comfortable lifestyle without needing to work.

You seem focused purely on income.

 

[Ed Barton]

I think China has a classic case of what Dr Freud would call doctor envy.

The topic has been done to death.

I'm closing this thread tomorrow.

Closing arguments please.

Because after this the topic will no longer be allowed.

With all due respect why? People are obviously interested in the topic and there has been no widespread 'pub fights' over the topic. Why not let it die a natural death (oncologists, cardiologists and ophthalmologists might disagree)?

 

[china]

My point previously is that income and wealth are not the same thing.

Income is the money you get on an ongoing basis. Wealth is what you accumulate by careful management of your income and investment. If your lifestyle expenses exceed your income, no matter how high or low the income, you will never accumulate wealth.

Most people here are focused on wealth, and many have succeeded in accumulating enough for a comfortable lifestyle without needing to work.

You seem focused purely on income.

I agree with you entirely.

However, zero income will mean zero wealth.

We are not all so fortunate to be in a position to do no work.

Some of us have to work to sustain our lifestyles, let alone accumulate wealth. And if we have to work, may as well generate the best income possible per unit of time.

 

[china]

With all due respect why? People are obviously interested in the topic and there has been no widespread 'pub fights' over the topic. Why not let it die a natural death (oncologists, cardiologists and ophthalmologists might disagree)?

Agreed, this has been a great topic for the Coffee Lounge, with lively, vigorous debate. I greatly appreciate the opportunity to contribute and value the input of other contributors.

 

[geoffw]

I agree with you entirely.

However, zero income will mean zero wealth.

Who said anything about zero income?

You're trolling.

 

[china]

Who said anything about zero income?

You're trolling.

There must be a certain correlation between income and wealth. I wonder how many life long disability pensioners have accumulated great wealth. I would think that a far higher percentage of doctors would achieve greater wealth than a group of librarians.

 

[geoffw]

There must be a certain correlation between income and wealth. I wonder how many life long disability pensioners have accumulated great wealth. I would think that a far higher percentage of doctors would achieve greater wealth than a group of librarians.

But that doesn't mean that you need a huge income in order to build wealth.

Many people with a big income have big expenses as you pointed out yourself.

The people in here who have successful built wealth have usually done it with an income below the mean- but the have been careful with what they have had, spent carefully and invested well.

To focus on income, and especially to focus on one profession with a high income, is missing the point of building wealth entirely.

 

[china]

Income is a tool for building wealth.

A job/profession is a tool for generating income.

All personal living habits being equal and investing prowess being equal, a high paying job leading to high income should lead to high wealth.

 

[Rolf Latham]

Wealth ?

back to basics

What is wealth................one (small ?) component is money or allied assets

One can be wealthy with little real money, and one can be dirt poor and be a billionaire............

Jim Rohn said you can have great lifestyle that isnt dependent JUST on money

ta
rolf

 

[Ed Barton]

There must be a certain correlation between income and wealth. I wonder how many life long disability pensioners have accumulated great wealth.

A high income can make a high wealth easier, but it doesn't guarantee it. Having a high wealth means you don't spend all your income. You've said that you fit this bill.

IMO you have a too shorter investment horizon. If you have little debt then you can take a longer term view; as you do.

100k in investments for a life long disability pensioner would be very good. For us it's a pretty crappy outcome. Horses for courses.

 

[china]

back to basics

What is wealth................one (small ?) component is money or allied assets

One can be wealthy with little real money, and one can be dirt poor and be a billionaire............

Jim Rohn said you can have great lifestyle that isnt dependent JUST on money

ta
rolf

I don't know about Jim Rohn but the Australian bureau of statistics and the OECD define net wealth in pure dollar amounts.

Trying to get into business class section of aeroplane without money is impossible.

 

[china]

A high income can make a high wealth easier, but it doesn't guarantee it. Having a high wealth means you don't spend all your income. You've said that you fit this bill.

IMO you have a too shorter investment horizon. If you have little debt then you can take a longer term view; as you do.

100k in investments for a life long disability pensioner would be very good. For us it's a pretty crappy outcome. Horses for courses.

Agreed, that is why the top 1% of income earners are often not in the top 1% of net wealth holders in any country.

In fact, in the BRW 200, there is not a single doctor there who has earned his spot on the list by provision of individual medical services.

 

[Mazda]

However, the pay off is when they become a specialist. That is the time, when within a year or two, their fast food colleagues are left far behind financially.

I'd disagree. Please add in 6 years of income for the fast-food employee and deduct 6 years of expenditure (plus ongoing qualification fees) for the medical doctor.

There are not many fast food employees who can sell burgers for 30 plus years. They will remove you because you are becoming too expensive and will rapidly replace you with a keen 15 year old.

Just as you assume that medical doctors WILL become specialists, please consider that those who start off as fast-food employees will also learn on the job. Many of them will move on to become managers in the food-services industry.

Unless you have a severe aversion to lots of cash,

Perhaps change the statement to 'unless you can afford the education for a medical degree'...

===

Edit:

In all the brouhaha, I have only ever sought to make one point. Please consider a medical degree if searching for financial security and the highest likelihood of consistently being in the top 1% of income earners.

Agreed, that is why the top 1% of income earners are often not in the top 1% of net wealth holders in any country.

In fact, in the BRW 200, there is not a single doctor there who has earned his spot on the list by provision of individual medical services.

... so, contrary to your consistent belief, being a medical doctor is not a 'just add water and mix' instant recipe for moolah and a spot in the top 1% of whatever it is you aspire to be?