Doctor (Physician) Salaries – Not as High as You Think

1. 1. The Financial Blogger

   I deal with several doctors and I noticed something very strange:
   about half of them don’t save much money! They make 250+ and they still have a hard time having more than 300-400K in their RRSP’s at the age of 50!

   When they just finished school, they usually get a 400K house and drive a nice car upfront. Since bank will lend them up to 200K unsecured credit, having a mortgage is quite easy!

   Oct 8th, 2008 @ 8:16 am

2. 2. Four Pillars

   I know a couple of specialists and I knew they are in the $300k range. I’m really surprised that GPs make $250k? They have several years less training than specialists so I assumed they would be in the $100-$150k range.

   I think the lack of a good income for so many years is the drawback. I believe interns make around $50k-$60k and of course students make less than that (if anything). Meanwhile all your friends will be outearning you for many years until you finally start making the big bucks.

   Very interesting topic!

   Oct 8th, 2008 @ 8:37 am

3. 3. FrugalTrader

   FB, that’s an interesting point that doctor lifestyles are generally expected to be higher due to their income. Higher lifestyle, along with high debt servicing payments means lower savings.

   FP, I’m not sure how they came about getting those numbers. Perhaps GP’s can make more if their clinics are busy? Whereas specialists mostly practice in the hospital?

   Oct 8th, 2008 @ 9:04 am

4. 4. MultifolDream$

   Those numbers look high to me. I bet they are much less here in Quebec.

   Oct 8th, 2008 @ 9:09 am

5. 5. MoneyGrubbingLawyer

   FT, I’ve got several close friends who are doctors, and those numbers are pretty much spot on. For doctors in NL, the numbers are currently just a little shy of the 2005 numbers you’ve got above- I know this because I was recently in a prolonged debate about salaries with a doctor friend after she took issue with my post about the raise package for gyn oncologists, and I got quite a bit of info from her.

   I don’t know if it’s fair to say that physicians deserve more- yes, they work long hours and are well educated, but so are any number of other professions that don’t make anywhere near as much as doctors (I’m thinking many engineers, nurses, academics, tradespeople, etc.). Most physicians will be in the top 1% of income earners across the country, and for people who have their salaries paid by the public purse, that’s not too shabby.

   Oct 8th, 2008 @ 9:25 am

6. 6. FrugalTrader

   MGL, are the overhead fees here in NL on par with what’s stated in the table? How about GP salaries? Is that approximately correct?

   Oct 8th, 2008 @ 9:35 am

7. 7. MoneyGrubbingLawyer

   The overhead rates here are roughly the same- 30-40% for most practices. The GP numbers that I have seen show that GPs on a fee for service basis (this would be the majority) usually make around $240k, while those who are salaried make less- closer to $150k.There can often be hefty retention bonuses as well ($30k +).

   Oct 8th, 2008 @ 9:46 am

8. 8. Nurseb911

   The overhead is what usually impacts a physicians ability to earn when their billing has certain limitations. GP’s, after costs, don’t really make an astounding amount of money even with 3-4 physicians in a mutually shared office. This is why you’re seeing teams of 2-4 grouping together to combine costs so that its more economical over the long run for them.

   Oct 8th, 2008 @ 10:23 am

9. 9. Unspender

   My partner is in medical school and plans to practice Ob/gyn. She’ll be a resident (aka intern) next year and that salary depends on the province. Across Canada, a resident’s salary varies. For Ob/gyn, I believe it’s between 40-50,000/year. Of course, most new doctors have a lot more student debt than other recent grads. She expects to have about $150,000 in debt by the time she graduates. It makes my $20,000 seem tiny, but I’ll never make six figures.

   Oct 8th, 2008 @ 10:35 am

10. 10. FrugalTrader

    Unspender, when your partner graduates, what kind of interest rate will she have on those student loans? Are they in the form of a line of credit? When she graduates in a few years, do you expect your family life style to increase proportionally to the increase in income?

    Oct 8th, 2008 @ 10:54 am

11. 11. guinness416

    Once you get through it you have a job for life though, right? That’s a bigger asset than an engineering degree. Every doctor I’ve met in Toronto appears completely miserable, although whether that’s the pay or not I don’t know. Our NYC doctors used to complain endlessly about insurance paperwork. I think the main benefit of the job is never having to sit shivering in a clinic waiting room for four hours. Well, that and seeing how proud your mother is.

    Oct 8th, 2008 @ 10:59 am

12. 12. FrugalTrader

    Guinness, there’s no doubt in my mind that being a doctor has the greatest job security around along with top notch salaries. However, if you’re not enthusiastic about medicine and dislike your job, then is the money worth it?

    Oct 8th, 2008 @ 11:04 am

13. 13. Dividend Growth Investor

    I guess another thing to think about the percentag of people that go to medical school and start interning but actually end up making the big bucks mentioned in FT’s chart?

    Imagine accumulating a 200K debt before you realize that medicine is not for you :-)

    Oct 8th, 2008 @ 11:14 am

14. 14. FrugalDoc ;)

    Let me put in my 2 cents as an emergency physician and regular reader.

    I think the numbers are likely a fair estimate of today’s situation, although those overheads sound quite high, especially considering the number of doctors who practice exclusively in the hospital.

    I went into medicine for ‘the right reasons,’ thinking that I wouldn’t really be paid that much, and was well aware of overhead issues and being paid effectively less than minimum wage during residency (interning). But now that I’ve been working for over a year, other than rock star and a few other rare jobs, I find it hard to think of a better job. I love the work (not true of all doctors for sure), I get an almost embarrassing amount of respect from society, I can work anywhere with ultimate job security, I can reap the tax benefits of incorporation, and I gross as much as dermatologists in 2005, working 13 shifts a month. As well, since I work in hospital, my overhead is low – parking, books, lawyer/accountant fee for incorpoartion, professional memberships.

    There are drawbacks. I must admit that the overhead and running a business side of family practice scared me off even though it’s an incredibly rewarding job otherwise. Many of my colleagues ended up with >100K in debts. Some of them could have scaled their lifestyle, though. I was also training at times when I could have had a job in other professions.

    In general, I agree with the points of this article. Someone going into medicine should do it for the right reasons. There are too many miserable doctors who didn’t, and there are better things to do if you want to get rich. That being said, I’m realizing now that it’s a pretty freakin’ incredible job.

    Dividend Growth Investor: the percentage of people who go to medical school and end up making the bucks in the chart is very high. Unlike many other professions, the barriers in Canada to becoming a doctor are mostly the admissions process. There is a very low drop out rate or failure rate after that, and, in general, we don’t have intense competition for jobs once in the workforce.

    Oct 8th, 2008 @ 12:10 pm

15. 15. Thicken My Wallet

    Sounds about right…

    You have to remember that the salary also represents lost years of income for being in school for 7(?) years and then being paid slave wages being a resident.

    Oct 8th, 2008 @ 12:40 pm

16. 16. David V

    Someone told me once that a high school graduate will make more money as an electrician then a doctor. I guess you can start working as an electrician immediately (well working towards the certification, but you’re still making money) versus paying money out to go to school for years.

    But we look up to doctors and down on electricians. I’m being a little dramatic with that statement.

    Oct 8th, 2008 @ 1:25 pm

17. 17. Little Ms.Scrooge

    Let me add a little info about docs from other countries who immigrate to Canada. For many of them, they have to prove themselves all over again with many exams. So for somebody who finished their basic medical training, then there is specialisation which takes a few more years and then a continent move can set you back a another 4-5 years atleast. I know many docs who have moved atleast 2 continents and in their late 40s or early 50s, still struggle to achieve a networth like yours FT. And the time away from family, how do you put a price on that? So even if you start your training for all the right reasons, your professional happiness ultimately depends on where you end up and how you are treated there. Does anyone remember reading about Britain sending as many as 30,000 foreign trained docs out in 2006-7? Some had been waiting around for 1-2 years in the hope of getting into specialist training. That does not sound like job security. Even in Canada today there are many foreign trained docs who work in other fields not related to medicine because they have not been able to get into the system.
    Just my 2 bits.

    Oct 8th, 2008 @ 1:38 pm

18. 18. Work no more

    Doctors with very high income usually incorporate. So they are only taxed at around 15% (BC 2008 rate for CCPC) and they can deduct lots of their expenses through the company. For investment, they can create a holding company to do so. They pay themselves low salaries from the company, so on the T1, they won’t get taxed at a high tax rate and the salaries are deductible for the company.

    Oct 8th, 2008 @ 2:55 pm

19. 19. FrugalTrader

    Work no more, that may be the case, but when they withdraw the money, it works out to be about the same as personal income. Like you said though, the biggest advantage there are the tax deductions and liability protection. See this post about corps and taxation:
    1. http://www.milliondollarjourney.com/private-canadian-corporations-and-taxes-the-basics.htm
    2. http://www.milliondollarjourney.com/private-canadian-corporations-and-taxes-scenarios.htm

    Oct 8th, 2008 @ 3:16 pm

20. 20. Jordan Clark

    Does anyone have any stats on what a laser eye surgery optometrist makes? At $500-800/eye for less then an hour of time I imagine they’re easily grossing over a million or two a year. So after whatever cut they pay to Lasik and other overhead they’re still making a much more then a regular doctor.

    Oct 8th, 2008 @ 4:00 pm

21. 21. FrugalDoc ;)

    FrugalTrader: About incorporating. Wrong about the liability protection. Docs get none from incorporating, unlike other businesses. And the tax does not work out the same when you take advantage of strategies like paying to lower income family members, universal life insurance, tax deferral, and paying yourself later when you have less income.

    Little Ms. Scrooge: Great point about foreign trained docs. They have it tough, depending on where they were trained. I think it’s important that we ensure competency, but I do not know why we make it so hard for foreign docs.

    Oct 8th, 2008 @ 4:19 pm

22. 22. FrugalTrader

    FrugalDoc, thanks for the correction, I did not know about the liability protection issue with corps and doctors. Question, what is the cost of liability insurance for doctors in Canada? Does it vary by province?

    Oct 8th, 2008 @ 4:27 pm

23. 23. FrugalDoc ;)

    There are 3 regions with different liability fees: Ontario, Quebec, and the rest of Canada. The highest rates are in Ontario, ranging from about 2000 to over 50000 (for OB Gyn). The good news is the prov. government reimburses the fees in Ontario (and I believe the other provinces) to lock them at 1986 rates. The fee for emergency is about $7700 but I pay $1500. Gynecologists only pay $4900 of the about $50000 fee.

    Liability insurance is a huge problem in the US.

    Oct 8th, 2008 @ 4:59 pm

24. 24. Tetsuo

    Good Post FT.

    I have to completely disagree with the statement that they should make more than this. Lets be very conservative and say they have an extra 100k in dept from an Engineer, and take 4 more years to start work. Being very very rough, ignoring intern wages, ignoring the fact an Engineer’s salary also starts low and slowly increases, ignoring the preference for doctors to incorporate and save on taxs, and using a very bad rate like 10%, if the Engineer starts @ 60k/year, the total difference after 4 years would be somewhere around 300k.

    Make than into an annuity @ 10% and that translates into a doctor making +30k/year to be “even”, but as above it seems the average is MUCH MUCH higher. Change my very bad assumptions into something more realistic and that number drops from there. I’d say in general, doctor’s salaries are unjustly inflated.

    Oct 8th, 2008 @ 5:03 pm

25. 25. Telly

    In reference to the Financial Blogger’s comment, if you’ve read the book “Millionaire Next Door” it seems the trend you’ve noticed is similar to what the authors found in their study. Of all the professions they studied, doctors tended to have the lowest net worth despite the high incomes.

    I would think after years of studying hard and then working for peanuts for a couple years, they feel they deserve to splurge. Who can blame them in a way?

    I went to university long enough to have earned M.D. status (8 years) but unfortunately I don’t make anywhere near the numbers in the chart so the lost years of income are not only a factor for doctors but also for those of us that either changed our minds (my situation) or partied too hard (also my situation ;) ).

    Oct 8th, 2008 @ 5:13 pm

26. 26. Aaron

    I’m a Family Physician in the Midwestern US. I have talked with friends in similar situations and it seems that the take home pay starting out is in the $125,000 range. Much less than on your table.

    Oct 8th, 2008 @ 6:14 pm

27. 27. Unspender

    FT: Most of the loans are from a bank credit line with a prime interest rate. It won’t happen for another 5.5 years, but I like to think we’ll be smart about money when the jump to a “real” salary happens. As I’ve mentioned we have a lot of debt between us, so I hope we’ll focus on that before we make any changes to our lifestyle.

    Oct 8th, 2008 @ 10:54 pm

28. 28. GeniusBoy

    I’m a doc in Toronto, and I love what I do. And I’m about the least miserable person you’ll ever meet. However, it’s taken me 19 years after high school, to get to where I am today. I graduated relatively “quickly”: graduated high school, did my 4 years Bachelors in 3 years, 4 years MD, 4 years of residency, 3 years of subspeciality, and 5 years of a PhD.

    I’m not a typical doc, in the sense that I have a PhD, on top of my MD, that allows me to have a research career to do what I love to do.

    When I think of the opportunity cost, (and I’m a health economist), it’s astronomically big. I could have had the safe and comfortable life, but I took risks, and in many ways, I’m being compensated for it.

    To be honest, I worked hard while I was doing my PhD: working to pay the bills, and supporting a family. Between school and work, I was putting in upwards of 100-110 hours a week. It was tough, but thankfully, I had a supportive girlfriend, now wife.

    I have low overhead nowadays, which means my $250K starting salary plus bonuses can pay off my over $250K in debt, and in 2 years, I’ve cleared my debt. When I started 2 years ago, I had a -$100K net worth, and now, I’m bordering on 200K, and climbing relatively quickly.

    If I set-up an office, I’m sure I could make $500K+, but that has no interest for me. I couldn’t do day-in, day-out office work. It just has little interest for me.

    FT: The salaries have gone up significantly in the past 5 years, secondary to the push from Alberta and BC. I know there was approximately a 20-30% raise across the board in Ontario about 3 years ago, and the recent contract calls for a 16.5% raise over the next 4 years.

    Little Ms. Scrouge: The system pays alot to make a doctor, and the return is something called “residency”, where you’re underpaid and overworked. (Actually, I think my residency was wonderful … I work far harder as a staff physician, but I guess I’m compensated better now.) Foreign physicians should also “pay their dues.” There’s a wide variation on the quality of foreign physicians. Some really drain our system, and refer everything, to avoid legal liability. Some are extremely competent and incredible value. But there are also wide ethical issues on our role in the “brain drain” in the global professions market that would be an entirely different discussion. I’ve also seen those let into our system that are clinically extremely scary. Canada used to be the most difficult health care system to get into, but there’s a value to ensuring the public can trust the health care it does get. Quantity does not always outweigh quality.

    I know why I do what I do. If I won 10 million dollars tomorrow and didn’t have to work, I’d still do what I do. I love what I do. I love making people better. I love researching challenging and what people once deemed, impossible questions.

    I wake up excited and wanting to be at work. I get to save lives, find cures, and give hope to people. As a dear mentor of mine said, “For the privilege to give this joy in people’s lives, I should be the one paying for the privilege.”

    FT: Thanks for the post …

    Oct 9th, 2008 @ 1:03 am

29. 29. Tony

    In my first two years of university I considered medicine as a career path. I ultimately decided against it because my anesthesiologist cousin told me I better really want it or it won’t be worth it. And that is absolutely true. Being a physician, I suspect, takes a great deal of personal sacrifice, especially the schooling part, and the job can be very demanding not only emotionally, but physically, and socially as well, as it does not often leave as much time for family as one might hope.

    For those interested in healthcare as a career, I would tell you to consider pharmacy. I did, and after 6 years of university, I was making $55 an hour my first day after graduation. Two years later I took a job for $60 an hour, 40 hours a week, no overtime, 9:30-6:00 with a half-hour lunch, Monday-Friday, no weekends, no holidays, with a $20000 signing bonus and potential for significant performance bonuses every year. The career is extremely rewarding as people also trust and respect pharmacists, I get to help people every day understand their medications and health, I get to learn every day about a field that interests me a great deal, and the best part: I have ample time to spend with my family. Oh, and no overhead.

    To be fair, I am in a high demand market, but even in large cities where pharmacists are a dime a dozen, the average wage is still $45-50 an hour. Something to think about if you’re one considering a health-related career.

    Oct 9th, 2008 @ 1:36 am

30. 30. Telly

    Tony,

    I have 5 good friends that are pharmacists (my 1st undergrad was Biology). They work in various cities in North America. Not one of them works 9-5 with no weekends, no holidays and they’ve been pharmacists for 10 years. It seems you’re very lucky where you’re at because from what I’ve seen, that type of schedule is very atypical. The salaries are quote nice though, if you can get past the schedules.

    Oct 9th, 2008 @ 9:26 am

31. 31. FrugalTrader

    Tony, i’m with Telly on this one. I also know a lot of pharmacists, and there are none here that don’t work ANY weekends unless you are a supervisor at the hospital pharmacy. Typical wage here is around $35-$50/hour. I agree though, there is a high demand for pharmacists.

    Oct 9th, 2008 @ 9:36 am

32. 32. Jeff English

    A lot of this has been canvassed already – but a huge point is that doctor’s rarely have the overhead of an office and a nurse anymore. Or the government subsidizes the costs of that office.

    I would also point out that doctor’s – either in the hospital – or in an office – always collect 100% of what they bill. Unlike other professions – there is no concern about the “accounts receivable”. Dentistry is very similar in that – insurance pays for almost everything – so there’s not much concern about overhead there either. (Dentistry is a good deal because of that – but the overhead is really a concern in that profession – unlike medicine).

    The other thing is that Doctor’s get a ridiculous amount of respect – some earned – but a lot – unearned. It is probably the one profession – where you can not know what is really wrong – and simply say – I’ll send you along to the guy who really knows – but you can’t see him for three months.

    I’ve also had the experience where a doctor will try two or three different medications to heal something and you have to keep coming back to see him or her. This does not give me a lot of faith in their abilities – and I see more and more that doctors are “guessing” for lack of a better term.

    Anyways – it might be a tough road – but you know what – what other profession do you have guaranteed employment – I mean – when was the last time you heard of any discipline proceedings where the Doctor was not allowed to practice?

    I have a hard time believing that the answer always is – pay them more – if they truly loved what they were doing – they would simply do it. A job is a job – no matter how you cut it.

    Now the real guys making a killing are investment bankers – get your MBA – hit the right job – get some big bonus money – and you never have to work again – plus – it seems that even if you screw up – the gov’t will bail you out – you’ll still get paid – and you can say that you didn’t see it coming – even though you were paid millions of dollars to see that very thing.

    Tangents are a terrible thing.

    Oct 9th, 2008 @ 7:33 pm

33. 33. Tony

    I would agree with previous commenters that I am very lucky in terms of schedule and it will not remain this way forever, as I am at a new store so we are slow for now. I did work at another company where I had quite a few 4pm-midnight shifts. But even with the schedule challenges that exist sometimes, I have rarely worked more than 40 hours in a week.

    Oct 10th, 2008 @ 2:27 am

34. 34. UpTooLate

    Great article and follow-up comments. One could spend hours addressing the many points made.

    I think the numbers are not far off for averages. Obviously we are looking at a bell curve with a leftward skew and the numbers almost certainly only represent doctors that are billing the system in some way and not those who have decided that the life is not for them. Increases have not been very large since 2005. My recollection in Ontario was that there was a fair increase in 2005 with some retroactive pay. This was after many years with increases in fees that were far below the rate of inflation. The numbers for the newest proposal are again below the current rate of inflation. (even the one given by the government!)

    Definitely don’t go into medicine for the money! In Canada, at least, it is still a calling.

    I became a specialist in a fairly efficient manner – 3 years engineering, 4 years medicine, 1 year intern, 4 years residency, 3 years subspecialty. I was fortunate enough to do medical school when it was still less than 4k a year and also at a time when interns/residents were actually starting to get paid. In my final year of residency I think it was 50k, interestingly in my final year of subspecialty training it was 40k! Hourly rates – let’s just say there were many weeks when I spent more hours in the hospital than out. Residents now are paid somewhat more but they are getting hammered by medical school tuitions that are 3 times or more higher.

    As far as modest RRSPs go – how could it be otherwise. I am 50. I maxed my contributions every year once I had an income, invested fairly reasonably, didn’t get caught in the dot.com bubble and was still less than 400k before the latest market fun.

    If you are gifted enough to get into medicine but you want the big money do the MBA or start your own business. Put in the same hours with the same dedication and your numbers should look better. Not as sure on satisfaction.

    Job security – yes. You are always needed somewhere. Not necessarily where you want to be but somewhere. Many specialists need a hospital to practice – if there are no openings – well see you later. Few specialist residents are able to set up practice in their ideal place. Battles have been fought over governments restricting places of practice.

    No overhead – really? A minority – think anaesthesiologists or ER docs. But then of course you have less autonomy. The former group especially. Overhead continues to be a major problem for most docs. The reason most don’t have nurses in their offices is because they can’t afford to have them. I share a busy office with 8 MDs. We have 4 nurses and 10 other support staff. The overhead numbers sound about right. Some hospitals do provide support staff in clinics run in hospital – these tend to be proportionally less efficient than non-hospital clinics.

    Foreign docs – don’t get me started. Canada should be ashamed to be taking doctors and nurses from developing countries where they are desperately needed and suggesting that they are easily employed in their professions. There are huge variations in training and societal expectations around the world. Canadian trained doctors are among the best in the world (I may have a slight bias – although I did do some of my training in the US and have worked on 4 continents). This is a result of the entire education system as well as the specific style of medical education and a huge exposure to patients during the apprenticeship of clerkship, internship and residency. It is also the result of the selection process for medical school. And on, and on – as I said don’t get me started.

    Good point on the Lasik question. Turns out that finding procedures that can be billed outside of the government’s fee schedule is a growth industry. Some relatively simple quick procedures are earning folks more than the most complicated surgeries that can take hours and require a large team and hospital resources. Remember that the most skilled surgeon in the country still only gets what the government says for doing the most complicated case imaginable. Most would be shocked how little that amount is.

    Oh yes, we are all government employees. Oh wait – no pension, no medical, no dental, no disability, no sick days, no maternity leave, no paternity leave, no paid vacation…

    Turns out that doing those on-call shifts is the health equivalent of smoking a pack a day for life.

    But there is the satisfaction.

    More than ’nuff said!

    Oct 10th, 2008 @ 2:37 am

35. 35. thomas

    personally I think the entire funding scheme is a farce! we pay our sports’ players millions of $ to play a couple score games per year to entertain us, but pay healthcare professionals a pittance to keep us alive! true gov’t irony dont you think?

    Oct 11th, 2008 @ 1:24 am

36. 36. Mike

    I am an intern in California, and have matched into a Radiology residency. I’ll become a specialist (assuming no setbacks in the next 5 years) relatively quickly – 4 years of college, 4 of med school, and 5 for my residency. Now, I was lucky enough to be able to match into a competitive, well paying salary. Speaking with fellows who are looking for jobs, they were able to get starting salaries around $300-350k with a decent lifestyle (50-60 hr work week, occasional night calls). This is about as high as it gets (outside of possibly radiation oncology and cardiothoracic surgery, maybe some more commercial-minded plastic surgeons or ophthalmologists).

    Now this seems great, until you factor in how much longer it takes and how little money you make until you start. 8 years of schooling where you PAY $20-40k in tuition. This year I am making $38k and working about 80 hours a week. Over the next 5 years my salary goes up about $2-3k per year, only because I live in an area that has higher living costs. So, in 5 years I make about $250k gross income. And I took 8 years of learning to get to that point, which set me back $300k, at least. That’s 13 years of schooling and training, for a net of -$50k.

    What about my college classmates who graduated and went into investment banking? 4 years of undergrad at about $120k, then start making at least $100-150k per year. At the end of my residency, they will have netted at least $1m assuming some upward movement. Even taking out the higher taxes, they are probably $600-700k ahead.

    Now how about someone who finishes high school and works at McDonald’s or Starbucks or some other low level job right out of high school? Even if they start at $15k a year, and get 10% raises each year, at the end of 13 years they have grossed $350k, and have no debt.

    So I will be $400k behind the slowly advancing fast food restaurant worker, with significant debt (somewhere in the $400k range), at the age of 31. Mr high school graduate is now an assistant manager making $50k to my $300k. He nets maybe $30k after taxes, while I net maybe $175k. And I need to pay another $25k in interest, leaving me $150k, or $120k/year ahead. So it takes me until I’m 40 before I’m back even (financially) with now Mr. Supervising Manager. And this is with one of the highest paying physician jobs available. If I go into family practice, I might be 50 before I’m even.

    I’m not asking for pity. I love my profession, and don’t regret it for a minute. But I would seriously need to reconsider if significant cuts in pay were needed to provide universal health care, or because of reduced medicare reimbursement rates. I would be very concerned for the future if medicine became less and less desirable, and our bright minds went somewhere else.

    Oct 12th, 2008 @ 2:20 am

37. 37. Mike

    Also, as a response to Jeff English – there are plenty of jobs where people do not know what they are doing. And, we are limited by the information we can get from the patient and from lab/imaging tests. I don’t know what situations you are thinking about in particular, but sometimes you just need to try multiple medications, or send someone off to a specialist. Most people do the same thing over and over again, and thus won’t be stumped often. You sell the same things every day, work with the same computers, talk to the same people. I don’t know of many other professions that deal with situations as diverse as most physicians do on a daily basis.

    I am just starting out my career, and I know there are things for me to learn. But it still shocks me how often people in the hospital talk to me with little respect because I don’t know all the parts of my job as well as they know their jobs (which they have been doing for 20 years). The surgical tech can’t believe I don’t know all the instruments, the pharmacist thinks I should know about all the drugs, the nurses don’t understand why I don’t know about some new type of bed or dressing, and the respiratory tech thinks I don’t know how to manage a patient’s ventilator. The case manager is upset that I don’t know a patient’s insurance coverage, and the social worker thinks I don’t pay attention to my patients because I don’t know where they live. In the clinic, we also need to know about billing and working with insurance companies. And then the patient with diabetes, hypertension, and lung disease doesn’t know why I need to keep trying different medications to control all these things. All this before they leave the clinic, light up a cigarette, and go eat at Taco Bell.

    Oct 12th, 2008 @ 2:34 am

38. 38. Ed Rempel

    Great post, FT.

    Some other types make quite a bit more, such as surgeons. I know several good doctors that moved to the U.S. where they can make double their Canadian pay.

    Most docs do seem to have less money than you would think. There seems to be an expectation that they will live a high life, with an expensive home, cars, vacations, private school for kids, etc. After paying for all that, there is generally not much left over to invest.

    This can be a big issue for doctors. If you live an expensive life and invest comparatively little, then how can you maintain that when you retire?

    This is why studies show that doctors have very low net worth in comparison to their income compared with other professions.

    I have also heard that a carpenter or plumber makes more than a doctor over their entire career, taking into account the time value of money. I have not verified this, but even if it is not actually true, it does support that it is not really worth being a doctor just for the money.

    It is also difficult for most doctors to save a lot of tax with a corporation, since they need nearly all their income for their lifestyle. Corporations really only help if you can leave income in the corporation and don’t need it for your lifestyle.

    Ed

    Oct 18th, 2008 @ 3:20 am

39. 39. Scott

    Canada has REALLY screwed up it’s health care system. But that is a whole other blog.

    Doctors, just like people in any other profession, will chase the money. So they (doctors, nurses, etc) get their first rate education here, move to the States to work, pay off their student loans and buy a house all in the first year. And in Canada….?

    A greater percentage of med students are now specializing because that is where the money is. Who wants to be a GP any more? Declining number of GP’s plus an increase in aging population = health care nightmare.

    Ed is right about the “Millionaire Nextdoor” being plumbers etc. The one that really made me shake my head was my barber. Not a stylist, just a plain ol’ barber-pole barber. He takes around 10 minutes to cut my hair and charges $12 and most people give him $15 (”keep the change” — smart pricing scheme, 20% of his income is “non-reportable”!). So…he can make $72/hr plus $18/hr in tips = $90/hr.

    $90/hr for a life long career that is recession/depression bullet-proof; extremely little education or specialized skills; three-digit student loans; no inventory; minimal overhead; zero stress; no heavy lifting.

    I bet his gross income is close to (or over) $100,000 a year.
    Oh yeah, and it’s 100% cash business.

    Barber vs. doctor — you decide.

    (As a side-note, my barber doesn’t do shaves anymore — fear of lawsuits. Could a surgeon ever stop doing operations and still get paid to be a surgeon?)

    Oct 18th, 2008 @ 4:39 am

40. 40. Ed Rempel

    Hi Scott,

    Good point, Scott. A former barber I had retired at 50 and moved to Hawaii.

    The “Millionaire Next Door” people we meet fall into mainly 4 categories – small business owners, frugal people, some high-income earners that invest heavily, and people that do a lot of leverage.

    People tend to admire doctors more than plumbers, but a plumber that builds his business and has 5-10 plumbers working for him is making considerably more than most doctors – especially after tax. The problem they run into is getting too focused on the cash economy and hiding money, rather than investing it.

    It is amazing how large a nest egg even low income people can amass by being frugal and investing heavily. There are a few like that on this blog. According to the book, the #1 vehicle driven by millionaires is the Ford F-150 pick-up truck. We have also seen a few millionaires that drive Honda Civics.

    High income people like most doctors tend to be equally high spenders, and therefore often have little more left at the end of the month than anyone else.

    The other problem they have is that they are usually the worst investors. The story around the investment industry is that doctors and dentists are the worst investors of all. One of the more reliable investment strategies is to ask your dentist how he invests – and then do the opposite! Many sales-focused brokers and planners target doctors and dentists, so they get marketed all the crap out there – and usually at the wrong time.

    But doctors and dentists often believe they are good at everything and smarter than everyone, and therefore often don’t take advice well. They will juggle their own account, plus several advisors and always add new money into whichever one did best recently – thereby consistently buying high.

    We have also seen people build significant wealth with leverage implemented properly. Part of why we are big believers in the Smith Manoeuvre is that average people that are able stick with a plan long term through ups and downs can use leverage to build a far higher portfolio over time than even most high-income earners build. The reason most Canadians struggle financially is that their portfolios are far too small. Their main asset is their home. It is not really possible to become wealthy just by maxing your RRSP’s.

    Riding out markets like we are having now can be a challenge for anyone with significant leverage, though. Leverage can be the “great equalizer” as a means that average people can keep up with doctors, but it takes the right kind of discuplined, long term focused person for this to work.

    Ed

    Oct 18th, 2008 @ 1:43 pm

41. 41. UpTooLate

    Just a little note to Scott.

    We are all entilted to our opinions.

    As a physcian who has worked and taught in over a dozen countries including the United States… my opinion is that Canada has the absolute best health care in the world. Sure I could ask whether you have watched “Sicko” but that is too far over the top – but don’t think it is too far from the mark. In the words of Jack Nicholson – ‘You can’t handle the truth.’ All health care systems are great until you get sick. But also in the U.S. heaven forbid that you are rich enough to pay and come in with some nonspecific complaint but are well (i.e. most of the time people go to the doctor) – in the words of Mr. T – ‘I pity the fool!’

    As to income: I would defer to one of my colleagues who came to Canada after 10 years of busy practice in a large U.S. urban setting and is ecstatic in Canada. Works less, makes more, doesn’t get sued!

    As I said, just my opinion. Canada rules! (Beleive it!)

    Oct 26th, 2008 @ 1:59 pm

42. 42. Scott

    True enough UTL.

    None of has 100% knowledge of any field/occupation, even if we are “experts”. So I only know what I know. For example, a friend who has brain cancer and neither his insurance company nor provincial health care will cover his treatments. Anyone have an extra $100,000 I can borrow? How much does a life cost these days?

    I guess overall I would have to agree Canada has a semi-decent and functioning health care system. It could always be worse(?).

    But focusing only on the income side of things, I’ve known four doctors (in a range of specialties) and a handful of nurses who all got schooled in Canada (UofA) then headed to the States to make their money, and make they did.

    I don’t know…I don’t think there is a Silver Bullet to any health care question.

    Interesting point, too, about getting sued. I read an article many years ago about the litigation rates in the States. Something like if you made $60,000+, in any industry, you had a 75% chance of being sued. An American phenomenon, lazy man’s road to riches — sue someone!

    Oct 26th, 2008 @ 9:47 pm

43. 43. Genius Boy

    I would also agree with Up Too Late. Having worked in the US, you practise a defensive type of medicine, to prevent litigation. You do the extra test, even though you know the yield is rather low, because if the 1 in a million thing shows up, you’re going to be sued out of practise.

    With the fall in the exchange rate to parity (well, it’s now 85 cents to the dollar), away from 65 cents to the dollar, the difference in pay isn’t as great as it used to be. I make more in Canada than in the US.

    But as one of my mentors used to say, “I should pay for the joy I get to give to people.” I don’t think you can say that on a frugal website, can you?

    Nov 7th, 2008 @ 12:35 pm

44. 44. researcher

    I have been reading a lot of these “Doctors salary” articles lately, and one thing keeps coming up. And that is the fact that doctors have to study for a decade so 150k salary is nothing. I would like to point out that graduate students who work 16+ hours a day and study for more than a decade to get their PhD and get a PostDoc don’t get even half that. They get paid 20-24k a year. Even after all that struggle if you are lucky you become a prof. adn you have work for peanuts for year and years till you become a full professor and then you may get 150k. So doctors out there complaining about long hours, very long time frame to finish your medical degree, should think again. I think some doctors are over paid.

    Dec 11th, 2008 @ 7:02 pm

45. 45. ewon

    to researcher,

    Given your name, I assume you are in a research field, and perhaps have been a grad student yourself

    My understanding is that being a graduate student in academics is perhaps one of the WORST field to enter in the financial aspects – the low pay and lack of job security until you get a tenure at a university. And even then, the pay is not high at all considering what they have put into, unless as a professor, you can start some profitable business from your research.

    It appears even worse when compared to the above-mentioned fields with much lower education investment (both in money and time) – such as electrician and plumbing.

    Hence kudos to those who are willing to make sacrifices in this challenging path. I hope all of you have considered the financial aspect in the decision to take on this path, and are happy accepting the consequence of your decisions.

    Dec 27th, 2008 @ 3:05 am

46. 46. Simple Life

    just wow

    i am so surprise. 60$/ hour for being a pharmacist?

    where do the money come from? why the hell do the pharmacist charge 12$ for dispensing drug while the workers in wal-mart get 7$ an hour.

    the health care field is so messed up.

    Jan 3rd, 2009 @ 2:35 am

47. 47. DAvid

    Simple Life:
    Its just supply & demand. Ever since the big chains decided they wanted to have a pharmacy department, there has been a shortage of pharmacists. In my town, there are more pharmacies than burger joints. If I had a skill I could sell for similar remuneration, I would look for that salary as well!

    DAvid

    Jan 3rd, 2009 @ 11:35 am

48. 48. Scott

    @ewon: “…kudos to those who are willing to make sacrifices in this challenging path. I hope all of you have considered the financial aspect in the decision to take on this path, and are happy accepting the consequence of your decisions.”

    Yet another reason modern capitalist society is failing. People are choosing careers based upon size of pay-cheque instead of the amount of fulfillment (you know, heart and soul stuff).

    It’s been well recorded that the number of GP’s is dropping simply because doctors can make more money specializing. This results is a shortage of doctors for the general populace.

    How many children (and I’ve seen it first hand) go into medicine or law simply because their parents wanted them to make lots of money? What % of society works at jobs/careers because of the money instead of for the joy or personal reward? Probably not a lot. It creates a vicious cycle and a dour society at large.

    Of course society values people who make their lives easier and more comfortable (union employees aside) and the pay scale reflects that. I have no problem paying a fireman $80K; I have a very big problem paying a politician $125K a year.

    Then there is the rarity factor, Tiger Woods makes a LOT of money simply because he is the ONLY one who does what he does. But it’s also what he truly loves to do, so he’s got the best of both worlds.

    Jan 3rd, 2009 @ 1:35 pm

49. 49. phd guy

    In comparison to other PhDs that require just as much time, and usually more brains, than getting a MD, physicians are TOTALLY over payed! Myself, 4 years honors BSc in physics, 2.5 years MSc in semiconductors, 4 years (with a noble prize winning supervisor) PhD in physics, 2.5 postdoc at Stanford = $110,000… I would say a 50% reduction in MD salaries. In addition medical schools should not limit the output of MDs.

    Jan 19th, 2009 @ 5:22 pm

50. 50. student

    phd guy…we dont need more physicists, we need more doctors. 50% reduction in physician pay = no new med grads. I do agree though that phd’s in many fields of study deserve higher pay for the education they put in.

    Jan 24th, 2009 @ 3:44 pm

51. 51. UpNorth

    What excellent comments. With my husband presently in his third year of med school, we’ve been sniffing around to figure out what our financial future holds.

    Prior to being accepted into med school, my husband spent 15 years as an Army Officer. He had 5 years left until he was eligable for a full pension. He was accepted into med school and the military program to train MDs. So, he is being paid his salary, $87,000, while attending school. His tuition and costs are paid for by the military. Upon graduation, he will owe the military five years (which he had to serve to get his pension anyway). He will then be able to retire with 25 years service (his time in school is still counted as pensionsble service). His pension will be based on his best three years. On the day he graduates his salary will double to $160,000. From there it goes up significantly every two years.

    In the end we should be retired from the mitary with a good pension coming in every month while practicing as a civilian MD. No debt, no overhead. Clearly, joining the Army isn’t for everyone, but it’s been viable in our situation.

    Jan 29th, 2009 @ 2:53 pm

52. 52. Elman

    @UpNorth
    How does one signup to study as a doctor in the army ? are there special requirements ?

    Jan 29th, 2009 @ 3:22 pm

53. 53. UpNorth

    There are a few different programs available depending on whether or not you’re a serving member. In all situations you have to be accepted into a medical school on your own merit and then apply for the program.

    If you have no experience with the military it may be worthwhile to join the reserves for a bit to give you a taste of what it’s like (granted the job would be totally different, but you’ll get a good idea if it’s something you could see yourself doing).

    If a civilian med student joins the military, they get their costs covered and a salary as an Officer Cadet. After schooling, the salary would go up to the $160,000 with likely 5 years owing. If you finished your contract then you would walk away without a pension, just your return of contributions. The military also gives you money every year for CE and pays all of your licencing fees. No need for insurance, soldiers can’t sue.

    I hope I don’t sound like a recruiter. You have to look at your situation and see if it works. I spent 8long years in the army and was happy to be free. My husband, on the other hand, loved it. Oh! Also keep in mind the fact that overseas tours are guaranteed, especially as a doctor.

    Jan 29th, 2009 @ 3:59 pm

54. 54. Brian

    I disagree with this article. It is a total ridiculous saying that Doctor Salaries are not high. I will make a clear statement: It depends on the doctor and their willingness to want to learn more. By gaining knowledge, people just come by and will just want you to become their doctor. I say it would depend on the doctor you are talking about. Those statistics you can’t simply follow. I would say it’s a simple general idea of the salary of a doctor. I say if you are well known more people will come to you. Now, from my person view, I feel completely offended with this article. It is ridiculous. In addition, if u say that doctor makes low salary then I say as being a doctor you got to invest in other areas to save up for your retirement.

    Feb 7th, 2009 @ 1:19 am

55. 55. Ontario Physician

    I am a physician in Ontario with about 5 years experience. Those who say physician salaries are too high are not taking into account the responsibility we have. ER Drs, can make several hard decisions with just one patient. Can I send this patient home, do I admit them to an already full hospital? What have I missed? Let alone treatment plan. Multiply that 25-30 times per shift. Each encounter is your responsibility. Literally a life can be at stake or at least significant disability. In what other profession does this exist?

    Feb 17th, 2009 @ 10:30 pm

56. 56. not surprised

    another reason doctors may not have much money in savings is b/c they give about 50-60% of their money during the first 5 yrs to pay of all their loans to study for 10 yrs or even more. it cost about as high as $200 000 and add the interest and the numbers are crazy

    Feb 17th, 2009 @ 11:57 pm

57. 57. Ontario Physician

    The comments about lifestyle are valid as well as I know many examples. I think because you are dealing with death, dying and illness on a daily basis it makes you very aware of your own mortality. I think there is a strong “you can’t take it with you mentality” in medicine. I know I have that attitude to some degree.

    Feb 18th, 2009 @ 1:07 pm

58. 58. FrugalTrader

    Ontario Physician: Have physician salaries raised much since the table in the article was created (2005)? If so, could list some new salary ranges for various positions?

    Feb 18th, 2009 @ 1:18 pm

59. 59. Ontario Engineer

    Ontario Physician, In response to your comments “Those who say physician salaries are too high are not taking into account the responsibility we have.” and “Literally a life can be at stake or at least significant disability. In what other profession does this exist?”

    Do physicians have a great deal of responsibility absolutely Yes, but to think that they are the only profession which has responsibility for public health and safety is in dramatic error. There are many other professions that have just as great a responsibility if not greater. For example and engineer can have just as much responsibility for public safety. In fact one mistaken calculation can not only endanger one life but MANY. There are too many examples throughout history to list but to think that physicians have some devine right to extreme wealth because they hold a life in your hands is ridiculous. There are a lot of other professions that have the same responsibility, they just might be harder to spot because the impact is not as obvious as the impact of a doctor’s decision.

    By the way Engineers can make 50k-80k for a long time and typically only crest 100k if they get into upper management. In addition engineers have to work MUCH harder and pay higher tuition during their undergrad then most students intending to go to med school. I know because I was doing my undergrad in Science (intending to go to med school) and switched into engineering. A decision that was based on what I had a passion for, certainly not the money.

    Feb 19th, 2009 @ 7:21 pm

60. 60. Ontario Engineer

    And going back to phD guys comments. My girlfriend has an undergrad in Mech. Engineering, Masters in Health & Rehab Science and is doing a Phd in Biomedical Engineering. She’ll likely end up researching and designing the implants and tools that doctors use to save lives yet she’ll end up getting paid a fraction of what the doctors make who use the tools she designed. Tell me there isn’t something wrong with that (looking at you Ontario Physician). A Physician is only as good as two things 1. His/her knowledge and ability. and 2. The tools that are available to him/her. If one of those is missing a physician becomes USELESS.

    Feb 19th, 2009 @ 7:32 pm

61. 61. Ontario Physician

    Ontario Engineer, point well taken, however I am referring to the number of day to day decisions one must make. Correct me if I am wrong but an engineer will work on a project for an extended period of time. I would highly doubt you would perform your calculations once and move on to the next project within 10-15 minutes. I am implying that salary IS related to the directness on the impact on someone’s life.

    Airline pilots would be the closest example I could think of and i know their salary range can be $ 250 000 up to $400 000 per year with no over head.

    How do you justify kindergarden teachers topping out at $94 000 after 8 years experience? Denturists making $300 000 per year, Dentists making over $1 million, lawyers making $800 per hour or real estate agent making tens of thousands one one deal?

    As far as your girlfriend, she comes up with a unique design/innovation, patents her product, starts her own company and the sky can be the limit….my point is that we choose what we want to do. If people are bitter about what they could have done then they only have themselves to blame. I don’t remember saying anyone has a devine right to anything, only trying to explain why things are the way they are. Laws of supply and demand also plays a role, if there was a surplus of physicians in this country, wages would certainly stagnate.

    Feb 19th, 2009 @ 8:42 pm

62. 62. Ontario Engineer

    Ontario Physician, I still do not understand your point about “salary is related to the directness on the impact on someone’s life”. If that statement were true Engineers would make the same as doctors. Doctors may make decisions that affect health and safety every 15mintues and engineers may make those decisions anywhere from once a day to once a month. The point is that each decision a doctor makes only affects ONE person. An engineer’s decisions can affect 10s, 100s, or 1000s of people. The difference on “impact on someone’s life” between professions is negligible. Some people may make the point that some engineers do not make decisions based on health and safety and that’s entirely true (depends on the business you are in), but the reality is there is no differentiation of salary in our profession in regards to “directness on the impact on someone’s life”. As a result I think your hypothesis is flawed. I would argue that doctor’s salaries are as high as they are because people will pay more for their health than anything else (especially if they’re sick). Because doctor’s are seen as the direct solution to disease they receive inflated salaries. The reality is that without Engineers and all the other professions that make it possible for you to do your job your skills would be useless. It’s only because the public doesn’t see the direct correlation that other professions have on their health (such as Engineers) that salaries are not closer to doctors.

    To address your supply and demand comment, there is little supply because med-schools have tight restriction on the number of entries. This creates an shortage of doctors pushing the salaries up even higher. If other professional schools had the same types of restrictions it would have the same affect on their salaries.

    As far as being bitter. I am not. I chose to do engineering over med school and I can’t imagine myself doing anything else (aside from being and astronaut or professional athlete). I doesn’t bother me that doctors make as much as they do but it does bother me when they complain about it.

    Feb 20th, 2009 @ 6:06 pm

63. 63. Genius Boy

    As I said before, I’m paid relatively well, but there’s a lot of compromises. I can sympathesize with the PhDers, since I went back and did my PhD while subspecializing, and trust me, it left a large hole in the pocket. Spend 7 years at the H-school in Boston, and you’ll understand what cost really is.

    So relatively speaking, as an academic, I’m paid a pittance compared to my colleagues who left almost 7 years early and entered the work force. But I get paid to do what I love to do. And as I said, for the amount of joy I get, I should pay for what I do. (I can’t say that on a frugal website, can I?)

    But I also take exception to the fact that I’m overpaid … how many overnights have I done and continue to do. How many lives have I brought back from certain death? It’s a large number.

    Do I need technology to survive, yes and no. Sure, I need the right drugs, the needles … but the tests and so forth, they’re helpful but not necessary on a day to day basis. The real mark of a good physician is careful listening, pure observation and acting upon clinical signs and symptoms.

    Supply and demand is one aspect of the high salaries, but there’s also an expectation, (rightfully or wrongfully), that a person that deals with an individual’s life is worth more. If you look around the world, even in places with high physician oversupply (e.g. Cuba, Phillipines or Italy), they’re still paid more. Why? People are willing to pay to improve health that affects themselves. (Actually, you could argue that in the complementary and alternative medicine market, as well. Really, the herbs don’t cost that much … but people will pay for it). Economics argues that goods made for the commons are worth less. Having said that, Ontario engineer, if you create something that everyone wants, like the newest Viagra, you can and will make billions! Just look at the engineers who are billionnaires, like RIM, or the comp sci geeks like Gates and the google guys.

    For the life of me, I can’t figure out why a surgeon or an anesthesist is paid astronomically more than another physician for the same number of hours. It isn’t purely hours of training. Part of it may be the fact that they’re on call a little bit more, but even factoring that into account, I can’t see the pay discrepancy.

    @FT: As I said before, the salaries are rising and will continue to do so, while there is a relative shortage. They can’t get enough people to work, right now. In Ontario, the correction has been 30-40% above your numbers above. It’s hard for me to comment, being inside an academic centre, but when I was outside, I made the same amount of money working 1/3 as hard.

    Feb 21st, 2009 @ 2:31 pm

64. 64. NS MedS

    @Ontario Engineer: Med schools do not themselves restrict the numbers of admitted students. Although tuition fees have doubled or tripled in the past decade, they are still a fraction of the overall very high cost of training new physicians – spots in med schools are restricted only because a limited number can get funded given the realities of government funding. In any case, salaries were still high prior to the beginnings of the present shortage, so such supposed “limits” on the training of new MDs have little to nothing to do with pay levels.

    @Genius Boy: Surgeons and anaesthesiologists are paid more than, say, GPs due to the procedure-oriented nature of their work. Generally speaking, the more procedures done by a particular physician, the more she’ll make. That’s why an interventional cardiologist will often make more than an infectious disease specialist or just about any primary care physician.

    Mar 2nd, 2009 @ 1:05 am

65. 65. mcfly

    Seriously? comparing engineers to doctors is like comparing a apples and oranges. Go to school for 10 years post high school and tell me your salary as an engineer isn’t well into the six figures range, there is more variability but it is most definitely around here. Also included perks, gps with there own office taking holidays do not get ‘vacation pay’ or ‘profit sharing’ or health care, dental care, eye care, life insurance, pension etc. No company takes care of this for them and hospital working docs benefits are usually quite low. Now as for affecting lives Ontario engineer, it seems to me there was a little scare from epidemics such as the avian flu, ebola outbreaks, any kind of mass exposure to toxins etc if you can engineer a cure for cancer great. Also docs are exposed to all of these nice healthy pathogens when diagnosing something a lot of people don’t think about. People have no patience anymore, it seems they go to the doctor with a sneeze they want a cure immediately we want people to do everything for us and to hell with the limits of the human body. A headache is caused by about a million (not a high estimate) things would most of you agree that if you hear hooves you look for a horse first not a zebra? Engineering arguably improves the ease with which we live, medicine improves our ability to live.

    Mar 13th, 2009 @ 7:03 pm

66. 66. Insight

    I beleive that here where I live in B.C. there are many rual areas. If you are becoming a doctor for “the right reasons” you can work in a rual area because there is a scarce amount of doctors there. Th B.C government is willing to pay of any schooling debts you have for you if you make a commitment to work there for at least a specific amount of years ~ I would say anywhere from 10-13 years. I might be wrong though.

    Mar 16th, 2009 @ 5:27 pm

67. 67. Bob

    Im a resident physician in Canada.

    What the general public does not realize is the amount of money, time, and responsibility put into getting a top notch medical education.

    The average graduating medical student debt level is 100k. To start making any actual doctors salary takes AT LEAST 10 years of education, and as many as 15 – or more!

    Residents make less than minimum wage to keep hospitals running, and your mothers and fathers from dying in the ICU.

    With this kind of responsibility and cost, its no wonder that medical students are avoiding family medicine. A recent UofT study cited an almost 100K difference between specialist physicians and family doctors. Who the hell would want to do family medicine when doing an extra two years of specialization nets you 100K/year more!? Thats the major reason I didnt do it. If Im working, I might as well get paid as much as I can.

    How much one is paid is an indicator of how easily replaced the job is. If FPs are paid the lowest in medicine, then this must mean that the government believes they are easily replaceable by nurse practitioners, naturopaths, foreign docs, etc. Do you want people who arent trained in Canadian medicine making life or death decisions for your family members? Apparently so, since nobody is questioning this pay disparity.

    If you want to bring specialist salaries down, then expect the smartest people in society to avoid medicine completely. If I wasnt getting paid well enough, I would not do it. The work is too hard, too important, and too rife with responsibility to accept less than an incredible salary.

    Mar 19th, 2009 @ 12:46 pm

68. 68. FrugalTrader

    Bob, thanks for the great comment, it good to hear feedback from other doctors out there.

    A couple things though, your claim that there would be no doctors unless they had high pay concerns me. The doctors who believe that are in the profession for the wrong reasons.

    And this quote:
    If you want to bring specialist salaries down, then expect the smartest people in society to avoid medicine completely

    Come on Bob, that’s a pretty big claim that doctors are the smartest people in society!

    Mar 19th, 2009 @ 12:55 pm

69. 69. telly

    Thanks FT, you took the words right out of my mouth (fingers ;) ) in your response to Bob. Unfortunately, sometimes the larger the salary, the bigger the ego! :)

    As far as why someone would practice family medicine, there are plenty of GPs that choose to do so because the work / life balance fits their lifestyle better and allows them to spend time with their families. Believe it or not, some people actually care about things beyond money.

    Bob, I hope you learn to tone it down a bit. Personally, I wouldn’t feel comfortable seeing a GP or specialist whose ego was as big as yours. Your notion that every decision a phsycian makes is “life or death” is pretty egotistical. I have a lot of respect for medical practitioners (trained in Canada OR abroad) but I’m also aware that a good chunk of the average GPs day is spent writing prescriptions for antibiotics so exalting physicians as gods is a bit over the top imo.

    Mar 19th, 2009 @ 9:12 pm

70. 70. mcmatterson

    I don’t know, I’m re-reading Bob’s post and not getting the “physicians are gods” vibe. I don’t think he’s claiming that there would be no doctors if the pay was low or that every decision is life or death. I’m not a doctor, but I’m sure if I was in the situation where I needed to decide between being a GP or specializing, I would think about making the same decision if the wage gap is in fact that high.
    I’m guessing the vast majority of doctors don’t slug their way through 10-12 years of post-secondary just to make a lot of cash. It’s certainly not “all about the money”, but I’m sure we can agree that money does enter into it, even for the most altruistic among us. Any doctor is going to have the opportunity to help people and contribute to society, so what’s wrong with thinking about yourself at the same time, particularly when you’re getting close to the time in your life when children may be arriving.
    On the same topic, I’d be interested to see a comparison between GP’s and specialists on number of hours worked and amount of shift work. I’ve read that GP’s tend to work a lot of hours these days, but in my (admittedly limited) personal experience I’ve rarely seen a specialist work anything beyond 9-5 M-F. Anyone have any information about the difference in quality of life?

    Mar 19th, 2009 @ 9:46 pm

71. 71. Tony

    I am a surgical subspecialist in the U.S, and make substantially more that of my primary care colleagues. I think that the disparity will likely end soon, due to the predicted dire shortage of primary care doctors here. Our current government is dealing with this with a new sense of urgency, trying to find a “budget-neutral” way to increase salaries in primary care (which likely means paying less to the specialists).

    I can honestly say that the quality of life of most specialists here is far superior to that of my friends in primary care. Less hours, far more pay. The biggest problem though is that when one makes a high salary, he (or she) is convinced that his work is worth that much! Any pay cut would be an insult. A doctor used to making $500K a year (and I make more that that) would feel it’s the end of the world if suddenly his income was reduced to $250 or 300K….especially if extended financially with a second home, boat, plane, etc.
    I therefore see 2 phenomena happening–first, a huge wave of retirements from specialists in their 50’s and 60’s (at least those who have enough money to retire), feeling that it’s not worth their time to work for less money than what they think they deserve. This will even worsen the shortage of doctors in the short term, even of subspecialists. Second, there will likely be resentment between doctors, those of the new generation of docs vs. the older docs. The days of super-high doctor salaries here will end soon, and combined with soon-to-be higher tax rates and the like, newer docs will never be as rich or able to live the “good” life as the previous generation (espec. during the Bush years). The older docs with money will be waving to them from the other side of the fence, which will become increasingly harder to breach…

    Mar 22nd, 2009 @ 4:51 pm

72. 72. Richard

    Hi my name is Richard. I hope you guys are having a good Christmas vacation. I love to help people, that’s why I wanna become a doctor. I think I can become one because I am really smart and I love my mom and dad. They support me and encourgage me to become successful as I will be eventually. Some people call me fob, but I think it’s really annoying. I am very outgoing and I have a great social life; I go to the movies with my mom and dad every week.

    Jun 7th, 2009 @ 7:22 pm

73. 73. Sump

    If you practise in Canada you are doing it for the Passion. If you practise in the US you are doing it for the Passion and the Money.

    If the Canadian government has not realized it yet. More and more Canadian grads are seeking US opportunities because the 200k in debt you will be after med school is so much easier to pay back once you are working in a US practise. There are salary caps in Canada. I mean how can a surgeon earn $250k a year in Canada and an uncapped surgeon in the US can make millions. Tis a joke indeed.

    Jun 17th, 2009 @ 4:47 pm

74. 74. ran

    as a pharmacist that was making close to 125000 a yr at the age of 23 when i graduated from pharmacy i worked for 3 yrs then went to medical school, having seen how hard it is to become a dr and how time consuming it is i believe now more then ever that dr are poorly paid especially family drs especially for the contribution to society health and wellbeing that they make, it will take me 10 yrs to make up what i lost by not working while in school, however my contribution to society as a pharmacist and GP will hopefully be well worth it for the community i work in i firmly believe drs should be paid alot more for there time, responsibilty and knowledge

    Jun 18th, 2009 @ 8:00 pm

75. 75. JQ

    Everyone thinks they’re underpaid, including hedge fund managers. Find me people who honestly truly think they’re overpaid and I’ll find you flying monkeys.

    Jun 28th, 2009 @ 2:15 pm

76. 76. JQ

    At: OntarioPhysician
    “salary IS related to the directness on the impact on someone’s life”
    I’m sure acne clearing dermatologists are saving lives and Lasik docs are curing blindness with their $550/eye ads in every newspaper – its pretty obvious when all they can talk about is self-esteem and not needing to wear makeup (acne) or glasses (Lasik). I know both of these specialties are very lucrative. That pretty much debunks your rationale.

    Everything’s a business, and how much you make is purely dependent on labor supply and service demand.

    Jun 28th, 2009 @ 2:24 pm

77. 77. Derek

    In general I’ll agree with most here that doctor’s certainly aren’t overpaid when taking into account net income over theit lifetimes, however, mcfly’s comments really irritate me. It seems very few people realize how much of their life is affected by engineers.

    The water your drinking…from a waste water treatment plant designed by an engineer.
    The car your driving…desinged by an engineer.
    Along a road and bridge…designed by an engineer.
    To a home/apartment…designed by an engineer.
    Where you’ll sit at a chair (manufactured by a process designed by an engineer) while typing on your computer (designed and produced by engineers).

    But of course those all just improve your life. I mean you could live without anything produced in a factory (which is everything) as long as you had a doctor to take care of you, right? Of course without engineers that cat scanner wouldn’t be there, the isotopes required for tests wouldn’t be available, and the pacemaker keeping the old ticker ticking wouldn’t be around.

    Jul 3rd, 2009 @ 3:13 pm

78. 78. fanman72

    Sorry guys but I have very little sympathy when I hear people complaining about their 155k “net” salary. Yes we realize the sacrifices you make in your 20s but in terms of long term income, job security, and respect you guys have it good.

    I got my degree in chemical engineering several years back. I’ve been on both sides of it in terms of difficult of how difficult many pre-med courses are and the pure chem e aspect as i specialized in biomolecular engineering.

    I’m looking at the six figure salaries listed here, and comparing it to my paycheck (65k/year) thinking what an absolute joke. Our work is surprisingly boring – something I was unaware of before I graduated, there’s absolutely no respect from society, very little knowledge on what we actually do for a living, and no understanding on the impact we make on people’s lives. People think products magically appear on the shelves at Wal Mart or Best Buy overnight. People think clean water, cheap, abundant food, just “happens”.

    The education is HARD, and our income doesn’t reflect the difficulty of the curriculum. I think the only people who have it worse are science academics who will never get tenure.

    Time to look into other careers. Unfortunately, many graduate schools are out of the option as my grades are shot to hell due to ridiculous deflated engineering curves.

    Maybe engineers and scientists in this country are ridiculously underpaid. That being said, I’m really curious how our financial crisis will play out. I’m not entirely surprised it happened as the emphasis in our country looks to have shifted from created and innovating products to moving money around and providing services. 20 years from now, I can’t imagine the jobs making the big bucks now will be doing as well down the road like banking or law.

    Jul 17th, 2009 @ 1:58 am

79. 79. cannon_fodder

    fanman72/Derek,

    I know that the engineering curriculum in university was one of the toughest. But, for my money, easily one of the most underpaid professions is a police officer in a big city. When there is a very realistic chance you will be injured or even killed on the job, the stress on your family life, the lack of respect from the public… there aren’t many jobs worse and only 1st Class Constables have a base pay greater than $70k in Vancouver (it takes you at least 4 years to achieve 1st Class).

    Jul 17th, 2009 @ 11:58 am

80. 80. Shawn

    In the United States, let the market determine physician salaries. The cost of the US healthcare system is crippling the US economy. We can’t compete anymore with other countries where healthcare is like a subsidy to their businesses. In the United States, the healthcare industry is not a free market, both the insurance companies and the AMA are gaming the system and keeping costs high. Pre-existing conditions aren’t covered and vast numbers of people are left with little or no insurance. I hope President Obama succeeds in his healthcare reform.

    Jul 17th, 2009 @ 2:50 pm

81. 81. Shawn

    Can you provide a source for those overhead numbers? They seem a bit high.

    While expenses can vary widely among medical practices, the vast majority can look to some benchmarks for comparison purposes. According to the CMA’s Physician Resource Questionnaire1, overhead rates are reported as follows: family physicians, 36%; medical specialists, 25%; and surgical specialists, 33%. Support staff—typically a practice’s largest expense,—often comprise 40%–60% of total overhead costs. The full-time equivalent (FTE) number of support staff generally ranges from 1.00–1.25 for each FTE physician. Other benchmarks include occupancy costs, generally in the range of 20%–30%, with the remaining costs of medical and office supplies, professional fees, telephone, information technology (including computers, billing, scheduling, electronic medical records systems, etc.) also in the
    range of 20%–30%2.

    Jul 17th, 2009 @ 4:02 pm

82. 82. FrugalTrader

    Shawn,

    Here is where the numbers came from:
    http://www.nationalreviewofmedicine.com/issue/2006/10_15-30/3_PM_your_practice01_16.html

    Jul 18th, 2009 @ 10:08 am

83. 83. TK waste management

    I work for Waste Management in Canada, and a although I take out the trash, it’s a darn important job. If there weren’t people taking out the trash think of how miserable people would be. They would get sick. When I hear that doctors are getting over 100k salary, i find that ridiculous. We work just as hard and have to work in dirty enviroments and dont get paid half that. Doctors are way overpaid

    Aug 6th, 2009 @ 9:13 pm

84. 84. TK waste management

    I work for Waste Management in Canada, and a although I take out the trash, it’s a darn important job. If there weren’t people taking out the trash think of how miserable people would be. They would get sick. When I hear that doctors are getting over 100k salary, i find that ridiculous. We work just as hard and have to work in dirty enviroments and dont get paid half that. Doctors are way overpaid.

    Aug 6th, 2009 @ 9:13 pm

85. 85. mike

    How hard is it to make 400K as a doctor in canada. In the US its not hard in fields like cardiology and orthopedic surgery

    Aug 11th, 2009 @ 2:17 am

86. 86. health for all

    FT, correct me if I’m wrong, but the comments I’m reading show some misunderstanding which, I believe, stems from a misleading chart. The chart does not distinguish between earnings and billings. Neither is the same as income. A gross income of $250k is far more appealing than $250k in billings, from which you need to deduct rent, payroll, insurance, pay corporate taxes (if incorporated), etc., etc. With anyone not on payroll, earnings rarely equal income.
    GPs gross about $155 (2005) as income. Internists typically wok at hospitals and their gross income is $310k. In one case earnings=billings and in the other earnings=gross income. So, if we compare apples to apples, there IS a huge difference between GPs and specialists.
    In the barber example posted (an unusually successful barber, I might add), I suspect the poster meant $100K in billings, which may result in 60-70k gross income. The internist “takes home” $200+ after taxes, and the barber “takes home” $50k after tax.

    Aug 17th, 2009 @ 7:36 pm

87. 87. FrugalTrader

    The chart is meant to show the amount of overhead that physicians face. I’m not sure where it is misleading?

    Aug 18th, 2009 @ 9:21 am

88. 88. Alexander A. Jaramillo

    I agree that salaries of doctors for the most part are adequate, but not for specialists, who place themselves on a pedestal and assume the attitude of take or leave it.
    The cost of liability as part of the total cost of any service related to health care has been a soar point for me for years.
    Not long ago, during a trip to Southern Spain, I developed a very severe pain in my back, then settled on the left side of my lower back. I went to a local clinic. One doctor, one assistant, two emergency beds, one computer; well, you get the picture. They asked me for a urine sample. Ten minutes later I was hooked to an IV. Twenty minutes later the pain was gone. Within 90 minutes I was out in the street, enjoying my trip as if the event had never happened. All for 87 Euros.
    So, Why is it that the same thing in this country would have taken days, hospital stay, multiple tests, and several thousand dollars?
    Liability. That is the short answer.
    We do need to change the health system in the US. But if the government does not find a way to reduce the cost of liability, we are still overlooking 40% or more of the total cost of Health care cost.
    I do understand that the overhead of a doctor is greatly impacted by insurance coverage to himself.
    What can the people of a democracy do to change this? Is there a means to raise this issue to an open debate? How can we get the media to address this topic more forcefully?

    Aug 22nd, 2009 @ 1:16 am

89. 89. PD999

    Great debate.
    Does anyone know what a typical Canadian Radiologist earns?
    In the US, they are near the top of the tree (www.rsna.org), averaging over US$400/year!
    Also, what is the Salary Cap in Canada? Maybe best to work part-time and still get a great salary.

    Aug 30th, 2009 @ 11:48 pm

90. 90. Chinstrap

    My spouse is a resident here in Toronto and we know many residents and practicing physicians. My comment is MDs now a days do make MORE than you think… The days of salary or billing caps are done.

    Spouse worked in ski town north of TO. Family doc spouse worked with grossed $27k a month on 3.5 days a week work! Overhead is only $5k for her share of the building that all the docs OWN (ie paying herself). gov’t chips in $$ for nurses, under Family Health Network.

    ER docs at fee for service hospitals (Trillium Mississauga) or St. Josephs, can make $600k-$1 million. You start doing procedures during a night shift and rates are doubled. Note that a pretty full month is 20 – 8 hour shifts.

    OB Gyne can make $400-$500 and most overhead covered by hospitals. A baby delivery is like $300 and doubles after midnight and more for a C section. One 24 hour call and a OB Gy can make $10,000. Not kidding.

    Spouse just came back from rural health conference where rural town were recruiting. Number one point for Elliott Lake was family physicians can make $400k-$600k there with incentives..

    Anyway, just shedding some light..

    Oct 6th, 2009 @ 3:30 pm

91. 91. Nystro

    The opportunity cost of lost income during all the years of training is high. For me, it is the example of all my high school friends who are retired on pensions with great benefits, indexed to inflation. They put in their 30 – 35 year requirement starting in their early 20’s. I started my job at 30. Prior to that, as an intern and resident, in my day, we made very little (13K as intern), especially calculated by the hour!
    I am jealous of my friends wintering in Buenos Aires at 55! Their 54K annual gauranteed and indexed pension with benefits….do they know how much they would have to put aside to fund that by themselves? They would have to have 1 – 1.5 million aside. So when people talk about salaries, I think it is very important to factor in these generous benefits and not just give the income number. It doesn’t tell the picture. I am often taken aback by the number of people who think., somehow, doctors also will get pensions. Well, we don’t. No pensions, no benefits. Just sock it away! I don’t know many who could get their retirement together by 55. Because doctors have high incomes in their earning years they can buy big houses, but that makes up a lot of their net worth.
    My other point is that the idea that “we are all equally meritorious” is very Canadian. We can’t compare other professions simply because they have long training and study time. Depending on the specialty, doctors really do take on tremendous responsabilities. Just the fact that someone can suffer or die because of an error can be a stressful burden; then you add public humiliation when your malpractice suit is published in the local paper. It makes for quite a stressful job.

    Oct 14th, 2009 @ 1:53 am

92. 92. Mark

    Consider that nurses make $80 000 after 7 years. With their benefits and pension that takes their salary well over $100 000. They also get paid training. Doctors also have no pensions or benefits, they have to buy that themselves. They also have to maintain their education or they can’t keep their license. They also have to pay that on their own. That makes most MD’s a bargain considering the extra hours, responsibility, and stress.

    Oct 26th, 2009 @ 1:34 pm

93. 93. CaucasianAsian

    Just thought I’d throw this into the mix as a point of contention, but more importantly something to be considered: doctors should theoretically always be on duty. That is to say that perhaps they are not overpaid. Keep in mind that as a doctor one would not only have the knowledge of how to deal with emergency situations when such situations arise, but also the ethical and moral obligation to apply said knowledge. Imagine, you are a doctor, you are “overpaid” at just say $200,000 pretax, post-overhead income, for arguments sake and simplicity, you board your flight to Hawaii for your Christmas vacation with the wife, kids, etc. All of the sudden, someone starts choking on their bits and bites, heaven forbid, and someone cries out “HELP!! IS ANYONE HERE A DOCTOR?”. Well there goes watching movies on those tiny annoying airline screens, you have suddenly found yourself back on duty.

    Personally I have no actual anecdote to qualify the above, but I am sure it happens–how frequently, I cannot say. Or even if you are a doctor, and out throwing away money at a nice fancy steakhouse and some gentlemen swallows his steak in the wrong way. You get the idea. I personally have never even fathomed the idea (until now) of an engineer having to pull a bridge (at least not usually as a spur of the moment thing, required quite promptly, or death my ensue) out of his ass when the surrounding society is instantaneously faced with a dilemma, but those “is anyone here a doctor” moments seem much more realistic.

    Oct 27th, 2009 @ 2:13 am

94. 94. Chinstrap

    CaucasianAsian:
    I am sure those examples do happen. I don’t think it is as big a deal as one might think though.. One doctor of a doctor I know was on a plan and had this happen. His wife urged him to go up but he said no as he had been an Opthmologist for 25 years and his medical skills in all non-eye related areas were non-existent! Fortunately, there was a nurse on the flight who helped out. To that point, I guess nurses, firefighters, police are always theoretically on duty. For me, as a portfolio manager and value investor, I am always researching new companies, trends, as well. It becomes your life whether watching TV, at the shopping mall, or on vacation overseas – I am always looking for new ideas.

    Oct 27th, 2009 @ 8:03 am

95. 95. aspiring surgeon

    I’m a high school senior who plans to become a cardiac surgeon, i have read every single comment posted here and have taken into account everyone’s facts and opinions…..that being said i think that a lot of people here have made very good points, i do however have my own view-point towards all of this and would like to share it: I believe that though, yes,you should go into medicine for the right reasons( that being the passion of it, helping people, etc..), it helps to plan ahead for your economic well being. The truth is that becoming a doctor or a surgeon like i will become takes roughly between 13-16 years, right now being 18 in my senior year, going to to college and getting my bachelors(18+4=22) will leave me at the age of 22, the age to fool around and make most out of the years that won’t come back right? wrong, right after those 4 years….choo! choo! here comes the medical school train(22+4) at the age of 26 i will have finished medical school, then here come my internship,residency, and in some cases fellowship years that will roughly leave me at the age of 32……32! ah come on that is the age where you’re already supposed to settle down and start making a family…..instead it will be the start of my career? and you want us to be more altruistic and demand to get paid less? for god’s sake yes i love medicine but not blindly enough that i would not think of the impact that going into this field will have in my social life, so looking at that impact i do expect that when i do get through the other end of the tunnel i get well compensated for it.

    on a side note: if there is anyone here who is in the same field or a field in medicine similar to the one i which to enter who wishes to give me some insight, it would be greatly appreciated.
    Thank you

    Nov 25th, 2009 @ 5:02 pm

96. 96. Chinstrap

    aspiring surgeon,
    go for it! my wife just finished medschool and is a resident physician. She is involved with other initiatives too with global health (overseas and NGO work), and a representative for residents at the national level. She just went through CARMS last year which is the match into a residency program. I don’t recall if any of her classmates UofT went into cardiac surgery of the 200 students she knows, they went the full gamut – family, OBGYN, anesthesiology, rad onc, Int Med, radiology, optho, derm, psych, gensurg, ENT, plastics, orthopedic surg, ER, neurology..

    We do know one ER doc who started in cardiac surgery but switched out b/c of the lifestyle. One thing, you are quite young and most likely once you get into med school and are exposed to all the different disciplines you will have more of an idea. Even med students/residents don’t know until the last year and even try and switch during residency so I don’t know how you really can know you would want cardiac surgery at this early of a stage.

    One thing to say about cardiac surgery is that it’s a low growth or even dying area… a lot of the cardiac problems now a days can be handled by interventional cardiologists (get in through internal medicine) through stents and balloons and stuff like that. Also, there aren’t many jobs out there for cardiac surgeries as there are only 10 cardiac surgeons at TGH in Toronto and so if you want to work outside of the big city there isn’t much work. So, be aware of jobs… for example with nephrologists, we know one who has started who masters b/c of no jobs and of her resident class of 5, only two got jobs and the others are doing Phd, masters and fellowships… So after 8-10 years of schooling, to get into big, downtown specialties they often make you do more work.. anyway, I hope some of this is helpful.

    Nov 25th, 2009 @ 7:25 pm

97. 97. NS MedS

    @aspiring surgeon: High school is more than a bit too early to decide on a specialty – it’s more important to consider medicine as a field first, not to mention what you will need to during undergrad to prepare for med school admissions. This is particularly so when you have no actual experience in medicine – have you ever actually observed a surgery before? There’s little about it that resembles “playing a tune” and most surgeries are not (thankfully) matters of life and death in any immediate sense. And it’s a small point of information, but thoracic surgery tends to be more concerned with the lungs and esophagus in contrast to cardiac.

    Anyhow, that’s just my opinion as a second-year med student interested in surgery. I’m pretty sure of that route (if not the specialty), but it’s still possible that I might change my mind during clerkship. It’s good to be thinking seriously about your future career, but I’ve little doubt that your thoughts will change over time – not least the fact that actually making that choice *within* medicine is 8-10 years away. That’s a long time.

    Nov 26th, 2009 @ 12:50 am

98. 98. aspiring surgeon

    NS MedS,

    hehe i guess hands down if i were to be testing who had more medical knowledge you would win( since i have none, clap clap to you ), but that’s not what I’m trying to get across…in fact completely the opposite. I’m posting here because I’ve read every single comment on this page, since this topic interested me, then i commented on what i thought about the whole thing, which was that yeah doctors do deserve to be well compensated for their work,and then i added a little more, which, me not knowing a lot about what the hell im talking about made me look like an idiot hehe…. though i may not know much i do look at it that way, the whole melody and tune thing i mean….it sounds stupid and probably i said it to sound corny or movie-like but yeah i have watched some operations being done mainly from this website:

    http://www.orlive.com/index.cfm

    http://www.orlive.com/umm/videos/tecab-totally-endoscopic-coronary-artery-bypass?cmpid=active_redirect

    and my overall philosophy i guess you could call it is that everything has to be done in a certain procedure or else things might not run smoothly or maybe not work at all( kind of like how you have to put your clothes on first before your shoes, it just doesn’t work right the other way around) hence my little melody-tune concept(sorry if i didn’t get my point across right, i mean…. i like your over all post, but it just seemed like you were mocking me instead of doing anything else). As far as surgery never being life-threatening…………………..

    To be more specific on what i have been currently looking into, it is a sub-specialty called Congenital Cardiac Surgery, and me being only 18 and just recently going on this rode(i haven’t really even began to be on my way to becoming an m.d, but I’m becoming more and more interested and passionate about it, so that’s a start for me) i was looking for some INSIGHT from any surgeons here already practicing or doing their residency, thats all NS MedS.

    Nov 26th, 2009 @ 4:03 am

99. 99. aspiring surgeon

    @NS MedS,
    “it’s more important to consider medicine as a field first” those were word for word of what my dad said to me, he is a surgeon himself, but practising on another country and i don’t have very good communications with him but in the little i have talked with him he did say that to me, i just wanted to mention that i guess……( in a way telling you that i didn’t see your whole post as offensive…..just a portion of it though hahaha)

    Nov 26th, 2009 @ 4:28 am

100. 100. Strap

     aspring surgeon,
     My wife just told me she thinks that there is one spot per year at U of T since the major heart surgeries are at TGH, Sunnybrook, and maybe St. Mike’s in TO. There are 11 spots across the country, one at each school but 2 are French and reserved for Quebecois..I would guess. My point is that its good to have options b/c it is very competitive b/c of limited spots and sometimes it doesn’t matter if you are good but good at politics, and kissing ass.. As an example, we know one General Surgeon trained in TO, who has two U.S. fellowships, one from Mayo in Liver transplants, and he can’t get into downtown Toronto because the old guard won’t let him in and keep making excuses like go get a PhD.. Consider you might end up pursuing your cardiac dream anywhere in the world that will take you.. maybe back with you dad where he works.

     So, if you get that one spot say of UofT, it is a 6 year residency to be a cardiac surgeon. Or become a General surgeon first (5yrs) and then do a 3 yr. cardiac surgery add-on. Then to do Congenital Heart surgery, you definitely need to apply and get a fellowship (2yrs), meanwhile a PhD is strongly encouraged…
     http://www.surg.med.utoronto.ca/card/programs.html

     Most likely, to become what you want to become will take (college) 4+ (medschool) 4+ (residency) 6+ (fellowship) 1-2 +Phd (done half-concurrently) 3 = 18 years. It will take you probably until you are 35-36 to become what a Congenital Cardiac Heart surgeon… that is if you get into medschool on your first try and don’t take time off for kids, transfer and take a few months off here and there. 30% of the class at UofT medschool already have masters degrees in medical biophysics, immunology, and have published papers before medschool. My wife know many people who won’t become full 5 yr. specialists before 35-36. Yes, it’s true.. then you have 15 years to work until 50 when you want to slow down.

     Family medicine is a good option now a days b/c you can do it in 2 years and then add a year of ER, anesthetics, or low risk OB. Plus, you can have your own business/clinic, be affiliated with a hospital, get supported by family health networks, and be flexible. It’s a great time to be in Family Med b/c the demand is huge and healthcare is slowly privatizing. Family Docs can make $300-$400 pretty easily now a days too..

     Nov 26th, 2009 @ 12:11 pm

101. 101. aspiring surgeon

     Strap,

     Thank you so much for your info, I thank you for taking the time to post back to me. I guess medicine has a wider range of choices(specialties) than i imagined…i just wanted to get some comments on how the lifestyle for someone who has to put in that much commitment is like, i mean it’s 15 years of my life so i wanted to know what i was getting into… but i guess like NS MedS said, i should focus on short-term goals rather than long-term since it will be at least ten years before i have to decide my specialty and my choices could fluctuate a lot.

     on a side note strap- i currently live in Florida and I’m a resident(since I’ve lived longer than 8 years here) and also a U.S citizen now, so my opportunities are even better since they are opening a medical school here in 2010-2012 next to UCF University of Central Florida(right next door to my house).

     http://www.med.ucf.edu/

     Againg thank you Strap~~~~~~

     Nov 26th, 2009 @ 3:42 pm

102. 102. KM

     In response to the foreign doctors comment: This is NOT the solution to our doctor shortage. Opening up more spots in Canadian med schools is the answer.
     I am currently doing my Masters in Biology, and I have applied to med school twice in Canada – no entry yet. I will try again after my Masters and I’m told I have a good chance. I will even go for a PhD and try again if I need to – medicine is what I feel I was meant to do and my sole purpose in life.

     I also have a good friend who is in the caribbean for med school right now. He doesn’t go to class – that’s right – he told me he sits on a beach and watches the lectures on his laptop that his teacher puts up online. You really want this lazy ass to come back here and practice medicine on YOU or your loved ones, when he barely attended his classes??

     Foreign degrees are NOT the same as here, and doctors who can’t speak English properly are not the answer either. Tell me how a doctor who can’t speak properly is supposed to explain a complex procedure or something to you. It won’t work. We need to find a way to keep the Canadians in Canada.

     Nov 27th, 2009 @ 3:24 am

103. 103. Strap

     KM,
     I feel for you as it took my wife several attempts before she got it. Here is some unsolicited advice. The 3 most important things: high undergrad grades, good MCAT, and good extra-curricular which is all wrapped in a well written application. If one of these is missing, ie grades or MCAT then it’s a serious impediment, and work to rectify (redo some undergrad grades – yes look into this and get high MCAT).

     Blindly chasing graduate work in sciences is not the answer for all schools. Some schools (talking Canada and Ontario specifically) do not put much, if any, emphasis on graduate work. U of T does have a separate Grad pool of applicants, so it CAN help there. My wife does did graduate work, published high impact, and was respected in her sciences degree which is actually under the Fac of Med. I recall researching at the time Uni. Western Ont and McMasters and it didn’t seem that Grad work helped.

     In a good/bad way, there are not enough medicine spots because our healthcare system is government controlled and a monopoly which is also kept reined in by the Royal College, CMA, OMA and other organizations in a union like way to protect their jobs, pay and lifestyle. It’s bad because we don’t have a free market in choosing/getting good doctors, on our terms, with good service and essentially are takers. It’s good for me and my family because my family will benefit through my wife has a stable, high paying, high demand job with little outside competition because of the regulations..

     Although this goes against what you preach, you might consider countries that have reciprocal agreements (think Australia, maybe Ireland as Ontario is accepting Int. Med Grad (IMG)) and there are several in my wife’s residency.

     Nov 27th, 2009 @ 2:07 pm

104. 104. Doc2be

     Hi there
     iam a doc2be,iam in my late 20s turning 30 next year,I read every single word posted on here,i value all your opnions and i thing changed my mind.
     I have passion and inspiration to become a doctor,love helping people.but i think that iam too old to follow that route of becaming a doctor as it takes a good deal of extra years.
     is there anyone with idea of what i should do to help underplevileged instead of medicine?

     Dec 11th, 2009 @ 12:28 am

105. 105. anengineerstake

     This certainly is an interesting post with many varying replies and opinions. I myself am an engineer having graduated with a degree in mechanical and then chemical engineering from Canada. There was a point in life where I considered pursuing a career in medicine though decided against it since I enjoy what I do (with days of complaning, which is typical to any professsion in all honesty).

     My two cents on this topic, I do believe Doctor’s compensations are unfair when you take an engineering standpoint. There have been many times when I have visited a GP clinic with my tummy aching only to find out that most of the diagnosis process was first based on history (doctors knoweldge) and then on medical technologies (engineered developed technologies) ie, Ultrasounds, MRI’s and all the other fancy gadgets that are used by the medical field. When it came to the former ie, doctor compentency there have been only a handful of doctors who have takent he sincere interest to determine what was wrong with the patient and using the knoweldge they gained in medical were able to diagnosis 9 out of 10 times the excat cause of a particular aliment (this is what I call experience) perhaps the same applies to engineers or any other professional folks.

     The rest of the GP’s relied on two approaches, one was to carry out the basis tests (cbc, alk phs, etc) and wait for a hematologist or pathologist or radiologist’s knoweldge of what was wrong with a person. Not to mention in the meantime the patient was suffering his or her share of pain till a firm diagnosis could be estabilished. The other approach viz a viz reffering to a Specalisit when it was beyond the scope of the GP, again this takes quite a long time in some parts of Canada. Finally, the patient visits the specialist who more than experience relies (atleast in the present era on sophisticated techology to diagnose a particular disease, typically CAT’s, PETs, MRI for disease as varied as cancers.

     Then it comes to the actual skill ie, when specialisits perform surgeries and other physical procedures. This I believe can truly be attributed to a skill that a specailisit doctor should have would have learned during his Medical school and practice (ie experience).

     So to me, all the years of medical schooling and all the high pay becomes pretty meaningless when the entire diagnosis rests on techonologies developed by engineers who are not compensated as much as doctors especially GPs. As far as responsiblities go, there are only a few GPs who are willing to take on responsiblities about making accurate diagnosis or taking calcuated risks in making headway in alievating patient suffering. Most of them shy away from the legalities involved and refer the patients to specialists again. So I do not really comprehened the talk about high medical insruances (which don’t really get used up much atleast not in canada) cause the GP either prescribes tylenol or suggests a wait and watch approach.

     I still try to imagine a world of Doctors minus all the fancy gadgets, ie PET , MRI, scans, or for that matter even X-rays (result of experiements in particle physics) but the compentation, ie Doc vs engineers, Doc vs physicists, doc vs any other professions in North America still seem to ellude me cause it defines my logic.

     I do not believe that Doctors salaries could be lowered (certainly not increase) . They have put a lot of time in school memorizing tons of stuff and paying highly to the school. However, the profession and the salary should reassess and realign itself with the real world.

     Personally I do not really understand how all the time, money and energy spent in medical school translates to better healthcare. It ulimately boils down to a business, a business of making and generating money.

     This post is not ment to undermine doctors (atleast not all doctors) in anyway, but just a way to see if all the compensation (high or low based on different opinions) is really worth the service we as patients or consumers get overall from the canadian health care system.

     Dec 22nd, 2009 @ 8:12 pm

106. 106. lily

     This is a great topic and really helpful for anyone considering MD career. I am 36, worked in pharmacy, and now studying nursing undergrad at Mcmaster. I am considering medical school. However, I know that my age is a limiting factor, so I am only considering McMaster school. They accept after 3 years of undergrad, and medical school is 3 full years. From what I read residency for FP is 2 years and for some specialties 4. By 42-44 I can start working and paying my debt. Competition is great but it is possible to get in with high udregrad marks, MCAT scores and strong authobiography. I always wanted to be a doctor and after many unconventional circumstancies( including the war, refuge, starting family and immigration to Canada) that led me to postpone it, I still want it. I will do because I love it, and after I considered all the downsides and tried easier careers/pathways, I still want it. Don’t get me wrong I love nursing. I just think I would be happier as a doctor. I am glad that this profession is well compesated in Canada. You could be a brilliant student, and amazing doctor but if you are not compensated for it ( and I mean really low salaries in developing countries), your enthusiasm and compassion will soon vanish, you will get bribed by patients and become bitter, prejudiced and unhappy doctor. I understand all the arguments pro and con high salaries for doctors or any other profession. It the end it is personal choice what to do for living. How much time and money you invest in education and how much satisfaction and compensation you get from your job you should consider before embarking into the chosen school/profession. I would not compare the responsibilities, salaries jobs and education, and make comments if some professions are under or overpaid.If investment menagers are making millions of dollars I still wouldn’t consider it as a career because I am not attracted to that field. I personally can do only something that I love and enjoy but I also want to do something that I enjoy and be compensated for it. After careful thinking I decided to try to get into medical school after third year of nursing and after I finish it. If I don’t succeed and I will continue into graduate nursing. I will be happier as a doctor but I would rather be a nurse with an experience when I turn 50, than just starting my medical career with a huge debt. My family is very supportive and we are doing fine on my spouse’s moderate income since I am in school. I am hoping to pay my loan first and I since I am not planning any extravagant life, expensive cars, or house, I think I will be fine on $100k+ per year. I will do what I love to do and set example for my children that you shouldn’t give up because of some dificulties. As for the health care in Canada, everyone is so dedicated and they provide an excellent patient care. The Government can make some changes to improve overall health by implementing better social policies. Whoever complains about treatment of doctors and nurses they should talk to immigrants about health care systems in other countries. I am sure that overall you would appreciate Canadian health care more.
     I would appreciate if anyone have some practical advice how to get into the McMaster medical school. My GPA is over 3.9, I am studying for MCAT ( they only look for verbal reasoning) and I have lots of extracuricular activities ( volunteering, tutoring, being part of nursing student groups, long work history and family obligations) I don’t know if I can do anything else to prepare. I am already in problem based learning program at McMaster

     Dec 27th, 2009 @ 7:35 pm

107. 107. NS MedS

     With all due respect to anengineerstake, I don’t think you appreciate that the skills employed by a physician are not always that visible. Certainly most procedures require a substantial amount of practice, but they can be learned comparatively quickly. You can’t teach someone to be a surgeon in a month, but they could become fairly proficient in any number of procedures in that time. But the ability to make sound clinical decisions – diagnoses, appropriate referrals, investigations, and treatment plans – is the most important component of medical training. Usually a history and physical are adequate to arrive at a sufficiently narrow differential diagnosis, but not always, and further investigations are frequently necessary for diseases that cannot be definitively nailed down without a CBC or imaging. And while engineers and basic scientists deserve much kudos for their contributions to medical technologies and instruments, it’s silly to suggest that designing a new type of cautery device is remotely comparable to using said device during, say, a large bowel resection.

     Dec 28th, 2009 @ 6:02 pm

108. 108. kw10114

     Would you guys say that working or volunteering in a hospital is a good way to see if you have ANY kind of passion or aptitude for the field of medicine? Are there any other ways to find out if going for med school is a right decision? I am a second year University of Alberta science student, but I am not sure what I want to do with my life. ONCE I decide that I want to become a doctor, I will do whatever it takes to get there. What do you guys say to all the students out there who are perplexed about their future?

     Jan 12th, 2010 @ 5:03 am

109. 109. UpTooLate

     Volunteering in a hospital is an excellent idea. First, to get a feel for what is going on and whether you find it interesting. Secondly, without significant public service/volunteer hours you would be at a significant disadvantage in the admissions process. There is certainly an interest in good marks but there is also much more emphasis these days on candidates who have gone out of their way to develop their people skills. All volunteer work or even paid work in applicable areas is seen as value added. Good luck.

     Jan 13th, 2010 @ 12:32 pm

110. 110. Duke

     Doc2be

     If you’re truly passionate about becoming a Dr., don’t get too scared by your age. I’m 33, in the middle of my 2nd degree and I’m getting ready for an interview at Dalhousie next month. I applied last year with no luck and will apply once more next year if I don’t get in before I give up…but only because there is only so much you can do to change how you look on paper in the selection process…not because of my age. I have a Biology degree and am doing a degree in Public Health right now. I love my current program and would HIGHLY recommend that you look into this it. It’s not demanding and is very interesting. The job market is strong in Canada now and doesn’t seem like it will slow down. It is similar to medicine in that there are many different areas to become an expert and you can have a direct impact on the quality of life within a community. It’s almost like being a Dr to a population instead of an individual. I know that if I don’t get into Med school, I will be happy having a career in Public Health and will be able to support my family and enjoy a comfortable lifestyle.

     Jan 13th, 2010 @ 12:33 pm

111. 111. Betsy R

     As an American who has been quacked on, ripped off, and robbed blind (well crippled) by the medical profession, I don’t want to hear them whining. Yes, I’ve been to a few non-greedy doctors.

     Some of the non-greedy ones seem to be doing quite well, living in comfy homes without too much excess.

     I too like what I read in The Millionaire Next Door. Many millionaires actually live in homes worth about $100,000 instead of $500,000. Just because a doctor is a doctor does not mean the doc needs to live in a $500,000 home and send the kids to the costliest private school. Doctors do need reliable cars to get to their jobs, so some costly reliable car expense is justified.

     I got really ripped off in the 1980’s, which I consider the heyday of fee for service. None of my local doctors would accept insurance assignment or bill me. So I’d have to pop down $75 to $125 at first on a credit card and wait for reimbursement.

     Then in the early 1990’s along came managed care with the copayments. First time that happened to me, I only had a $5 copayment. Okay, so it went up to $10, $15, or $25 later.

     But when the patient is only paying a small copayment, doctors can and will order every test they can and sock it to the insurance company.

     If you have to go from one doctor to another, like from a GP to a specialist, it’s easy to see who is not greedy. Greedy doctors order tests at each visit. The nongreedy docs request the tests from the referring doctor and only redo them if questionable.

     Every job is stressful. Doctors aren’t the only ones under pressure. As for their life saving pressures, well, I’ve repeatedly walked away with untreated illnesses from quacks who didn’t want to do anything other than preventive medicine: play with the blood pressure cuff, test cholesterol, and screen for cancer.

     These doctors quake at the sight of a sick person. Then I end up having to pay and pay till I find a doctor who can treat a sick person. That’s one reason for high health care costs.

     The high student debt for graduating doctors is a relatively new phenomenon, corresponding to the inception of student loans. I don’t want to hear any whining on the student loans. Payment amounts can be adjusted according to income.

     Medical doctors went to school on the buy now, pay later plan. But, when they are delivering services in their offices, they want you to pay them immediately. They usually take copayments now because the insurance industry forced them into that.

     But they know the insurance company will pay them for their services, in less than 30 days. If you don’t have insurance, you are expected to pop out a large amount of money right then and there. When I work a regular job, I expect my employer to pay me within one or two weeks after the completion of a pay period, not immediately every hour of the day.

     Now I’m on Medicare and most of them do accept Medicare assignments. My Medicare payments, which I check on my statements, tend to be less than I paid for services in the 1980’s in the old days of fee for service. So I assume Medicare is close to the real cost of health care.

     Doctors lose money on Medicaid, but not on Medicare.

     When one of the Bushes was president, thet prez would pop off about the old days when doctors treated patients free one day a week, but now couldn’t do that because of malpractice fears. Duh??? They don’t do it now cause they know they can bilk someone else for money and let the indigents flood the emergency rooms.

     I say, pay the doctors in produce and livestock, like in the old days

     Feb 1st, 2010 @ 12:10 pm

112. 112. Betsy R

     I like what the doctor who said he’d practiced in several countries, and that Canada had the best medical system.

     American doctors don’t do squat for the “nonspecific” illnesses just like I put in my first post. Most of what we go to the doctor for is nonspecific.

     Most of us don’t and won’t need a heart transplant.

     Greed pays a significant part in the profitable preventive medicine industry in this country, but I think there are some other contributing factors. Transplants, cancer cures, etc., are the glory work. I am not sure all of the factors going on here. Yeah, the drug industry promotes its chemicals. Yes, people do get cancer, and yes, the medical profession has made progress in treating cancer.

     The average US doctor can’t function without a blood pressure cuff.
     But if you have an illness with symptoms, it’s all in your head.

     Try and get a mole or a wart remove, and see how far you’ll get. But you can get heart surgery. They’ll saw through your chest bones and plunge their hands intro your heart.

     Look at the obstetrical industry, when lots of babies come into the world without advanced degreed birth attendants throughout the world.

     It seems like there is a desire to control people through American medicine, but not a desire to treat illness.
     .
     Physicians salaries are much too high in the US, especially since the US is not training doctors to treat nonspecific illnesses with symptoms.

     Feb 1st, 2010 @ 12:30 pm

113. 113. Jon

     I have been accepted to the University of British Colombia Okanagan (UBCO) and the University of Alberta (UofA). I am debating on which one I should attend. I know UBCO gets some shine from UBC Vancouver but if anyone could help me with this process it would be a huge help. I believe tuition is about the same. Which has the best reputation and is overall better?

     Now, I have heard of a few programs where after residency, I can go up North and work for a few years and they’ll help me pay off my debt. Does anyone know how much they can help me pay off? I will be getting 10000$ from my family to start off for my bachelors and the rest of the money is for me to find…

     Feb 4th, 2010 @ 7:47 am

114. 114. finally done

     Interesting thread.

     I just finished residency/fellowship as a surgical subspecialist and I can tell you that incomes and overheads are all over the map. I pay 20% as a flat overhead rate working out of a hospital. I currently bill about 70k per month so my after expense income is about 650k. That being said, there are some docs in the same specialty in my city making 200k after expenses. Others make much more.

     This would have sounded great to me 13 years ago when I finished high school but I can say with certainty that I would NEVER do it again. There are very few things in life as draining as a surgical residency. There were times I really thought I would have an intracranial bleed the next time my pager went off after being up for 40+ hours at a running pace with people literally dying in front of me.

     There are many things about my job that give me great satisfaction but I can’t say that giving up my 20’s and developing a personality disorder as a result were worth it! I really hope my kids decide on a different career path.

     Mar 6th, 2010 @ 2:36 pm

115. 115. Fork in the Road

     Thank you to all who have replied! This thread held my attention throughout.

     I have been on the fence for the past two years after completing my undergrad about entering medicine. Last week I attended an interview to enter the faculty at my local university.

     Reading this thread has helped immensely in my decision to, or not to, enter medicine. I especially enjoyed the numerous comparisons to tradespeople or even restaurant workers. It seems as though the question, in a financial sense, is to live now and then in retirement or to live from ~30-55 and still have a somewhat difficult time retiring at that age. Of course job security and the respect given from society is not factored.

     Even though reading this thread has helped, it has not made my decision. There is still a strong urge to enter into the world of small business as an entrepreneur where the earning potential is without ceiling but the risk is inheritably similar. I see this an option leading towards an easier/earlier retirement and similar financial success given equal dedication.

     This is more a personal comment possibly to hear myself type, but feel free to comment on anything I have said.

     Mar 9th, 2010 @ 5:36 am

116. 116. Greed is Good

     My 2 cents on this.
     You can make even better money by having dynamic personality, kissing relevent a$$es and working your way up the corporate ladder. Make influential friends, contacts, be in a comfortable position making 250-500k each year as a Director, Sr VP etc by making high end presentations to the board, executive lunches, playing golf, traveling to various parts of the world-clocking air miles, spend friday-sunday at the cottage while other poor souls (people working under you at your work) are working from home on saturdays toget a better review. If you get fired, you have a million dollar severance pay.

     Mar 29th, 2010 @ 1:25 pm

117. 117. Gas Man = tired guy

     Canadian Anesthesiologist here

     Friday “on call” 30 hrs in hospital.
     Saturday “off” – left hospital at noon
     Sunday “on call” 30 hrs in hospital
     Monday left at noon
     Tuesday will work about 8 hrs
     Wednesday will work about 8 hrs
     Thursday on call again = minimum 24 hrs in hospital
     Friday “off”

     So Friday to Friday I will have worked 100 hrs. And yes that is a real 100 hours in hospital the whole time and very little of it sleeping.

     Annual income +/- $500k
     No pension, no dental, no medical, no vacation pay, ect.
     On call 1 night in 4, 2 weekends each month (one Saturday, one Friday/Sunday). Calls usually only 24hrs but sometimes it hits the fan and you stay longer.

     Someone wondered why anesthesiologists and surgeons make more than family MD’s. Look at the hours. I bet our hourly rate is not that much different (though my after midnight premium gets my hourly rate to $300/hr) Daytime rate closer to $120-180/hr. It’s just because we work so many hours. Sure a dermatologist is “on call” but how often is he actually called into the hospital? I live there on call. Try calling your family doc after 5pm. Bet you get a message “for emergences go to your ER”. Guess who’s ass is in the hospital to take care of yours?

     My lawyer charges me $580/hr, their assistant $350/hr. No idea what they would charge me if I called them at 3am. Call a plumber after midnight and they will probably charge you more on an hourly basis that I will for your emergency caesarean section where I take care of your life and the life of your baby.

     That all said, I love my job. Would not want to do anything else. But I know these hours are shortening my life. Usually have someone die on me about once a month or 2, a baby die about every 4-6. Even that is rewarding because we did all we could and I am damn good with the families. (don’t get me started on the home birth, all caesarean sections are evil crowd. Maternal mortality is 20-30% in countries with poor health care. Look around at your pregnant friends, 1 in 5 would die!). Cord around your babies neck and won’t come down the vagina? Baby dead in 48 hrs, you dead in 4-5 days. Oops, placenta won’t come out. Dead from blood loss in 24 hrs or by infection in 4-7 days.) Ask around for friends who had a C/S and why. In labour for 48hrs, well it was not going to come out on it’s own. That said I agree our current rate of 25% C/S is too high when the accepted average should be around 15% (total average, includes repeat C/S because after you had one a vaginal birth = 1/1000 change of uterine rupture and if that happens you have a 15-20% chance of dying and your baby has a 50-75% chance of dying). I totally understand why that is though, our society really does not like it when you end up with a dead or handicapped baby because “Dr. why did you not do a C/S earlier”? So when things look crappy for the baby the obstetrician tends to jump to the knife.

     I will also second that our system is damn good. Not perfect. Some waitlists suck. Ontario laying off nurses about the stupidest thing I can imagine. Why is it that every time they close a wing in my hospital, it gets converted into administrator offices? Cancer care is generally excellent. To the guy with the friend with the brain tumour, I’m sorry to hear that but every brain tumour I ever dealt with that was treatable, was fully covered by our system. I also do palliative care though and know that there are several times when there is nothing more “medically” that can be done to cure and we switch to symptom control and quality of life. I personally am happy the government will not pay 100’s of thousands for chelation therapy or other unproven therapies when the money can be spent on things that are known to work. We as a society need to decide where the money is best spent because we do not have unlimited resources in doctors or nurses or money or… Crappy thing about life is it always comes to an end sooner or later.

     Summary = great job. 14 years of education post grade 12 (5 yrs undergrad, 4 medical school, 5 residency), great money (but hours suck), pretty much guaranteed job security (awesome), no benefits, tons of responsibility (peoples lives can literally be in your hands). Averages you listed in your graph are pretty much right, just add 15% or so to bring them up to 2010 numbers.

     P.S. Incorporation only defers taxes. What you leave in there grows at the lower tax rate but anything you take out is taxed at your marginal tax rate. When you pay yourself a salary from the corp to get your RRSP eligibility you actually pay and EXTRA 2.5% “payroll tax”. Yes, did you know companies pay a tax for the privilege of paying their employees. Another benefit though is income splitting though it is not as great as it used to be.

     PPS. Please everyone please stop smoking, eat right (no fast food or processed foods please) and get regular exercise (come on, 30 min a day going to kill you?). I can’t tell you the number of obese, out of shape smokers who keep trying to die on me. It really makes for a crappy night and everyone acts surprised when uncle bob, 250 lbs, 1 pack per day smoker does not do well after a surgery. If you need an emergency surgery, or any surgery in general, please be thin, in good shape and a non smoker, it will make our jobs a lot easier. Old is ok, it’s the others that kills me because those are modifiable. You’ve heard the one about how the vascular surgeon puts his kids through university right? Bypasses down, amputates up. In a year I will often have 1-2 patients our department will operate 7-10 times on. Obese, smoker, diabetic. Vascular disease. Blockages in the blood vessels. Bypass aorta to femoral. Blocks. Remove clot. Blocks again. Bypass axillary (arm) to femoral (leg) (yes we actually run a gortex tube from the arm artery through your chest and abdomen to your legs). Blocks. Ect, ect. When you run out of vessels and your legs start to die from lack of blood we work in reverse. Amputate toes. Then fore-foot. Then below knee. Then above knee. Guys (and it is mostly men) often are still smoking through this. Stupid, addictive cancer sticks.

     Enough ranting. I’m going to bed.

     Mar 29th, 2010 @ 10:00 pm

118. 118. AmericanMedStudent

     I’m a 3rd year medical student in America, and with the recent overhaul in healthcare in the US, medicine is no longer profitable for a doctor. I’ll be $200k+ in debt by the time I graduate, and will be making pennies even after I finish working for minimum wage throughout my residency.

     I came across this article through a google search for Canadian physician salaries. I’ve been seriously considering practicing in Canada as a surgeon; I think you Canucks might find many more of us American MD defectors in the coming years. I’d be interested to hear any Canadian MD’s opinion on the future of medicine in Canada, and whether or not you see it being more/less profitable then the new US system.

     Apr 3rd, 2010 @ 3:01 am

119. 119. Katia

     My husband is graduating med school next month. We are Canadians and plan on remaining in Canada. The same situation applies here with debt and the small salary in residency. One thing to consider is our tax rate which is quite a bit higher than yours.

     What is the projected salary of a US surgeon? Gen Surg?

     Apr 3rd, 2010 @ 11:29 am

120. 120. Fresh Doc

     Hey guys, Internal Med doctor working in NJ at the moment, just finished up residency about a month back (woo hoo!) There, intro finished.

     Let me just be perfectly frank here, Doctors ARE overpaid. Sure med school is tough, but anything which pays off in the end in life is tough. Try asking executives who work way more than docs, and get to that position at the age of 45-50.

     Docs always talk about how much responsiblity they have and how they work the longest hours, but really, the work isn’t that hard. You’re simply examining a patient, discussing treatment and providing follow up. But, just like a resume, Docs like to “stretch things out” and make it sound like it’s the worst thing in the world. I’m not afraid to say it because I think Docs just do this for some empathy after their harsh years in Med School (which sucks, I must admit) I make about 180k a year now, overhead is paid by hospital and I don’t spend much.

     Note on Investment Banking: I love how this profession is just thrown out there when we talk about medicine, check out the student doctor network forums, you will find everyone throwing around “ibanker” These jobs are not only incredibly difficult to get, but also work insane hours, way more than any doctor.

     If you can get an undergrad degree AND stay on top of your class at an Ivy league school, you have a chance, otherwise you can forget investment banking, because large firms like Wells Fargo and Goldmann Sachs only hire out of these institutes, other applications are simply discarded (I know this because I talked to a GS executive once over the phone, just straight called him up and told him to be frank) and no, like everyone else here I don’t “have a cousin in i banking that makes millions” who the hell are you people fooling? Also, please stop pointing out the fact that it takes 11+ years to become a doctor and that you will be in “$160k+ in debt.

     If it’s REALLY that bad, then why did you decide to do it? I’m sure most of you knew something about what med school costs before making the plunge? Oh did you do it because “its youre passion no matter what?” well I’m sure you had other passions as a child, painting, singing, etc, why not do that?

     Second, I mentioned the grueling hours in I banking, and those are often 100 hours a week or more on AVERAGE. It’s a very mentally taxing job because you are constantly crunching numbers and your superiors will treat you like shit, because they are the big boys, and you’re just small time compared to them. Plus most first year analysts suck and are asked not to return, so have fun making 120k or so for a year or so until you get tired of the red tape and quit.

     May 4th, 2010 @ 1:08 pm

121. 121. Kevin - in Canada

     - The time doctors spend in school and the cost of tuition is something that should be rightly remunerated (preferabley while they are attending), but that does not mean they should be getting paid for their invested time being educated or for the work they do post school at their current rate, not if we value work based on the level of onerousness, effort and sacrifice which is what I think we ought to focus on. As a few of the above doctors have admitted, their jobs happen to be extremely fulfilling and empowering, not to mention reletively comfortable in comparison to most labour jobs.
     The long hours are something to take into consideration, however I don’t understand why they should even be allowed to monopolize all that time working while others cannot, furthermore many other people making a far lower income doing tiring, boring, back breaking blue collar work as opposed to the reletively desirable tasks of a doctor can also work extremely long hours, usually working 2 or more jobs and not recieving over time pay. I think the question boils down to, how do we want to value? Do we value based on how important a person’s position in the economy is, or do we value based on how undesirable someone’s life is by virtue of the day to day activities they are compelled to suffer through, I for one prefer the latter.

     P.S., My mom is a medical secretary who does all of the boring but necessary work that doctors don’t want to do and she is paid aprox. 40k /yr in comparison to her “ROCK STAR” like MD of a boss who makes upwards of 145k / mo……No, that’s not a typo i’m serious, 145k every goddamn MONTH!!!! So yes to sum up, doctors are way over paid and so are most professionals.

     Jun 24th, 2010 @ 4:26 am

122. 122. ohmygoshhh

     i am going to be an undergrad at university of houston with the major of biology and minor in english. my dream has always been to be a doctor. I liked the job because i can help people and that is a feeling you can rarely get from doing work.

     and i thought it would pay well.
     reading all these posts by people older than me is really freaking me out and im not so sure i can do this anymore.

     how difficult is med school? i want to get into Upenn after 4 years of undergrad.

     and will i really make 4000 a month as a resident?

     Jul 28th, 2010 @ 11:38 pm

123. 123. KY

     You are absolutely right when you say going into medicine is about the ‘passion’ and not the money. As an internist in the US making 110K a year (a laughable amount if you ask the specialists), I never feel the need to make any more like the specialists do because it’s not about how much you make. If you do want to accumulate wealth, what’s more important is ‘how much you save’ as opposed to ‘how much you make’. Doctors in general are not very savvy with their finances. There are specialists making north of 500K/year with tons of material goods, but have very little to speak of when it comes to their net worth. There’s this strange need on the part of physicians to keep up a certain ‘image’. I know of a physician couple in NYC making 400K combined, who had to borrow from their parents to buy a 1.5 million dollar condo. Quite silly if you ask me.

     Aug 3rd, 2010 @ 2:08 pm

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