for those deciding between law school and med school......
Posted: Tue Mar 10, 2015 4:14 pm
first time poster here, but have browsed boards for a bit.
My background is I'm a fairly early career general internist/hospitalist in a medium size city in the southeast. Not a small town, but not Atlanta either. I also do addictions work(hence the username), but make most of my money as a hospitalist. I've been out of residency 4 years. My wife is an in house lawyer now(Id rather not say where) who graduated from Duke Law and spent three and a half years in biglaw before transitioning in house. I'm just one guy, but I feel like I may be able to help at least one poster out by clearing up some misconceptions.
For starters, I realize the number of people seriously debating between law school and medical school is very very small. That said, hopefully as someone who has experience in medicine(and knows tons of people in the community in various specialties) and at least a superficial knowledge of law/biglaw/t14 stuff/whatever, I can help at least one poster out.
What I think students should first realize is that these forums grossly mischaracterize the market, employment prospects, general work conditions, etc of most physicians. Now to be fair it's not their fault, since a lot of the mainstream media does as well(which is where we get a lot of our assumptions from). Here are the biggest misrepresentations I see thrown about:
1) residents are poor and work insane hours. Maybe at a few programs in some specialties, but this is not the standard. It's been several years since I've been out of my internal medicine residency(which is 3 years), but I engaged in moonlighting activities a good bit as a second year and even more as a third year resident. Yes, my base salary as a resident those three years was about 50k(a little higher today), but by November of my second year I was making an extra 4k a month(minimum) moonlighting in various hospitals. My pgy2 year my combined salary was about 100k, but my pgy3 year I made 85k moonlighting for a total salary of over 130k. In internal medicine and other primary care fields this is not unusual at all. I know residents who made over 175k total their last year. Emergency medicine is another short residency where pgy3s moonlight a bunch. Same for psychiatry. Also, the average hours worked(you can look it up on Freida) for most residents who aren't neurosurgery residents or surgery interns is reasonable....think around 45-55, sometimes more or less depending on the program. It's not bad at all, and furthermore you can select what you want. If you know you want a laid back residency, well pick one!
2) You guys are looking at the wrong salary indicators. Surveys put out that you can easily google are not the best indicators. What you want is mgma. That's what all the hospitals and hospital systems use to determine salaries. Also, you drastically(at least from what Ive seen here) underestimate what inpatient primary care docs like me make. I work 7 on/7 off. I get to work about 730(but have to have my beeper on at 7am) and leave around 445(but have to keep my beeper on until 7pm)...that's the nature of a 7/7 hospital gig. My base salary is 265k. This is more than it says in the surveys, but that's because the surveys include a whole bunch of stuff that isn't particularly relevant to the real world. It's kinda like law in that way- you know, how average salary surveys at one law school may report grads make 90k at graduation, even though we know nobody makes 90k(bimodal distribution of course). The truth is I have no idea where these surveys are getting their numbers that show hospitalists(ie inpatient internists such as myself) make 210k on average.....but for someone who wants to be a community hospitalist in most areas it doesn't reflect reality. This is low.
But the main point(because that salary averages undershoot by a good bit in primary care) is that this is only one possible income stream. Keep in mind that's a 7on/7off Im working. I am still in my 30s....what am I going to do the other 7 days? Do I work nonstop? No, of course not. But just piddling around a little bit during those other 7 days(or alternatively picking up two 12 hr shifts that week) is going to pay another 3k or so those 'off weeks'.(the going rate for locum hospitalist work is 125-150 per hour). Now I choose to do suboxone clinic because it's what I enjoy, and I make another 85k or so throughout the year just piddling. So really, my salary as a community internist is over 350k per year. With a fairly light schedule and bunches of time off. In a not so bad community, and obviously internal medicine is a not very competitive residency(although I went to a good state med school, many of my colleagues went to carrib schools).
I'm just trying to point out that the primary care doctor busting his/her hump and slaving away for 160k is not reality. Are there people in internal medicine making 160k? Sure, but that's the occasional academic gig with a very light clinical load...that's not a common job. Just doing general community non-academic work is going to put you at least at 235k, likely more. Heck even the VA(veterans affairs) is paying 225k now for hospitalists, and that's a laid back job you barely have to be alive for.
So I make 350k in primary care, but if I had more business sense(or was willing to work more hours or had more drive), I could make a lot more.
Now my wife on the other end? She makes pretty good...around 115k now. But there is a BIG DIFFERENCE between 350k and 115k. Sure, she made more than this when she was an associate for a few years out of law school, but my lowest salary post-residency was always at least 90k more than her highest salary before she left her firm(even with bonuses). But the important point to note is that she is a SUCCESS STORY(isn't she?). She
1)went to the right law school(or at least one of them)
2) she did well there and got the 'right' kind of firm job
3) she stuck it out in biglaw for long enough to lateral to a 'good' early career in house job
Comparing her career path to mine, it is clear there were 10x the potential pitfalls and stumbling blocks in hers. I didn't really excel at anything(relative to others) once I get in med school, whereas she excelled every step of the way.
3 for 3, and you know what? She still works harder than I do in a job she considers less satisfying(and is less secure) for about 1/3 of the pay.
My background is I'm a fairly early career general internist/hospitalist in a medium size city in the southeast. Not a small town, but not Atlanta either. I also do addictions work(hence the username), but make most of my money as a hospitalist. I've been out of residency 4 years. My wife is an in house lawyer now(Id rather not say where) who graduated from Duke Law and spent three and a half years in biglaw before transitioning in house. I'm just one guy, but I feel like I may be able to help at least one poster out by clearing up some misconceptions.
For starters, I realize the number of people seriously debating between law school and medical school is very very small. That said, hopefully as someone who has experience in medicine(and knows tons of people in the community in various specialties) and at least a superficial knowledge of law/biglaw/t14 stuff/whatever, I can help at least one poster out.
What I think students should first realize is that these forums grossly mischaracterize the market, employment prospects, general work conditions, etc of most physicians. Now to be fair it's not their fault, since a lot of the mainstream media does as well(which is where we get a lot of our assumptions from). Here are the biggest misrepresentations I see thrown about:
1) residents are poor and work insane hours. Maybe at a few programs in some specialties, but this is not the standard. It's been several years since I've been out of my internal medicine residency(which is 3 years), but I engaged in moonlighting activities a good bit as a second year and even more as a third year resident. Yes, my base salary as a resident those three years was about 50k(a little higher today), but by November of my second year I was making an extra 4k a month(minimum) moonlighting in various hospitals. My pgy2 year my combined salary was about 100k, but my pgy3 year I made 85k moonlighting for a total salary of over 130k. In internal medicine and other primary care fields this is not unusual at all. I know residents who made over 175k total their last year. Emergency medicine is another short residency where pgy3s moonlight a bunch. Same for psychiatry. Also, the average hours worked(you can look it up on Freida) for most residents who aren't neurosurgery residents or surgery interns is reasonable....think around 45-55, sometimes more or less depending on the program. It's not bad at all, and furthermore you can select what you want. If you know you want a laid back residency, well pick one!
2) You guys are looking at the wrong salary indicators. Surveys put out that you can easily google are not the best indicators. What you want is mgma. That's what all the hospitals and hospital systems use to determine salaries. Also, you drastically(at least from what Ive seen here) underestimate what inpatient primary care docs like me make. I work 7 on/7 off. I get to work about 730(but have to have my beeper on at 7am) and leave around 445(but have to keep my beeper on until 7pm)...that's the nature of a 7/7 hospital gig. My base salary is 265k. This is more than it says in the surveys, but that's because the surveys include a whole bunch of stuff that isn't particularly relevant to the real world. It's kinda like law in that way- you know, how average salary surveys at one law school may report grads make 90k at graduation, even though we know nobody makes 90k(bimodal distribution of course). The truth is I have no idea where these surveys are getting their numbers that show hospitalists(ie inpatient internists such as myself) make 210k on average.....but for someone who wants to be a community hospitalist in most areas it doesn't reflect reality. This is low.
But the main point(because that salary averages undershoot by a good bit in primary care) is that this is only one possible income stream. Keep in mind that's a 7on/7off Im working. I am still in my 30s....what am I going to do the other 7 days? Do I work nonstop? No, of course not. But just piddling around a little bit during those other 7 days(or alternatively picking up two 12 hr shifts that week) is going to pay another 3k or so those 'off weeks'.(the going rate for locum hospitalist work is 125-150 per hour). Now I choose to do suboxone clinic because it's what I enjoy, and I make another 85k or so throughout the year just piddling. So really, my salary as a community internist is over 350k per year. With a fairly light schedule and bunches of time off. In a not so bad community, and obviously internal medicine is a not very competitive residency(although I went to a good state med school, many of my colleagues went to carrib schools).
I'm just trying to point out that the primary care doctor busting his/her hump and slaving away for 160k is not reality. Are there people in internal medicine making 160k? Sure, but that's the occasional academic gig with a very light clinical load...that's not a common job. Just doing general community non-academic work is going to put you at least at 235k, likely more. Heck even the VA(veterans affairs) is paying 225k now for hospitalists, and that's a laid back job you barely have to be alive for.
So I make 350k in primary care, but if I had more business sense(or was willing to work more hours or had more drive), I could make a lot more.
Now my wife on the other end? She makes pretty good...around 115k now. But there is a BIG DIFFERENCE between 350k and 115k. Sure, she made more than this when she was an associate for a few years out of law school, but my lowest salary post-residency was always at least 90k more than her highest salary before she left her firm(even with bonuses). But the important point to note is that she is a SUCCESS STORY(isn't she?). She
1)went to the right law school(or at least one of them)
2) she did well there and got the 'right' kind of firm job
3) she stuck it out in biglaw for long enough to lateral to a 'good' early career in house job
Comparing her career path to mine, it is clear there were 10x the potential pitfalls and stumbling blocks in hers. I didn't really excel at anything(relative to others) once I get in med school, whereas she excelled every step of the way.
3 for 3, and you know what? She still works harder than I do in a job she considers less satisfying(and is less secure) for about 1/3 of the pay.