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





Once upon a time, when I was still in junior high school, I aspired to be a doctor.  Why?  For all the wrong reasons.  First, because my parents wanted me to be one, and second because it was a profession that made a lot of money.  Fortunately, after doing some research in high school about what’s required to be a doctor, I realized that being a doctor is not about the money, it’s about the passion for practicing medicine.

It takes real commitment to be a physician.  To become a specialist, it takes at least a decade of training/education, long hours, low pay, and a large amount of loans (for some) to finally make it to the big leagues.  Even once you’ve graduated, most specialties require long hours along with periodically being on call.

Back to the topic at hand, doctor salaries.  When most of you think about doctor salaries, most think that they are paid like rock stars.  There are some numbers thrown around like some make $500,000/year and more, which is true for some, but not for all.  While the initial figures are high, doctors have to pay a rather large overhead fee which doesn’t include income tax.  This overhead fee includes insurance coverage, a provincial government fee and other misc expenses.

Below is a table that is a bit dated (2005), but includes the average salaries of various doctor specialties in Canada.  I added a third column to the original table to include the overhead as a percentage of their salary.

Gross and net earnings rose in 2005
Gross Net Overhead
Dermatologists $360,000 $240,000 33.0%
Internists $310,000 $200,000 35.5%
Ob/gyns $320,000 $195,000 40.4%
Pediatricians $250,000 $160,000 36.0%
Psychiatrists $190.000 $160.000 15.8%
GPs $260,000 $155,000 40.4%

As you can see from the table, the average doctor pays around 35% of their salary to overhead fees.  What’s left over is then taxed at the highest income tax rate.  Mind you, making a $155,000+ salary (in 2005) is pretty darn good, but for the work and time commitment that doctors put in, they deserve more.

Back to you, was your impression that doctors make more than they actually do?

Any doctor readers out there?  Have doctor salaries increased much since 2005?

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195 Comments, Comment or Ping

  1. 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!

  2. 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!

  3. 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?

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

  5. 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.

  6. 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?

  7. 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 +).

  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.

  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.

  10. 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?

  11. 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.

  12. 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?

  13. 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 :-)

  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.

  15. 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.

  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.

  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.

  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.

  19. 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

  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.

  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.

  22. 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?

  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.

  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.

  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 ;) ).

  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.

  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.

  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 …

  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.

  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.

  31. 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.

  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.

  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.

  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!

  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?

  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.

  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.

  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

  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?)

  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

  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!)

  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!

  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?

  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.

  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.

  46. 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.

  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

  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.

  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.

  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.

  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.

  52. 52. Elman

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

  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.

  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.

  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?

  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

  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.

  58. 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?

  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.

  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.

  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.

  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.

  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.

  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.

  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.

  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.

  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.

  68. 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!

  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.

  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?

  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…

  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.

  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.

  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

  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.

  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.

  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.

  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.

  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).

  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.

  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.

  82. 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

  83. 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.

  84. 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

  85. 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.

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

  87. 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?

  88. 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.

  89. 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..

  90. 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.

  91. 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.

  92. 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.

  93. 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.

  94. 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

  95. 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.

  96. 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.

  97. 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.

  98. @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)

  99. 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..

  100. 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~~~~~~

  101. 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.

  102. 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.

  103. 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?

  104. 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.

  105. 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

  106. 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.

  107. 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?

  108. 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.

  109. 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.

  110. 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

  111. 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.

  112. 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…

  113. 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.

  114. 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.

  115. 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.

  116. 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.

  117. 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.

  118. 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?

  119. 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.

  120. 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.

  121. 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?

  122. 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.

  123. 124. cjojay

    While I agree with much of what you say, I am slightly confused by your statement that: 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.
    I don’t understand. Have you not just described every professional in every profession? As an engineer for example, what are you without your knowledge and abilities? As an engineer, what are you without tools that are available to you? You are called an engineer because you are knowledgable ands skilled in the field of engineering. In medicine, doctors are taught to be good clinicians, using knowlegde of the human body alone as much as possible to detect disease. Then, they are taught to support their clinical findings or suspicions with instrumentation. The mantra is never to depend entirely on investigations to diagnose. Your diagnosis begins with clinical suspicion. Some of the best physicians are actually in the poorest countries with the least number of technical resources. Even a radiologist Hence the countless hours of human anatomy and physiology and clinical medicine. Sure, once you diagnose, you should treat, which requires the use of surgery or medications. Back in the old days, your local physician also made his or her own drugs through research, experimented in surgical technique etc. I am not opposed to people commenting on how much other professions deserve higher paycheques but I am opposed to people pretending that the work of a physician is not as challenging as it is.

    I agree that there are other fields that make decisions that could affect human life. However, there are few professions in which these decisions are as immediate as in medicine. Imagine an emergency physician for example, as someone already mentioned. There is nothing like fighting to save a life and seeing the hopeful faces of a patient’s family and friends and having to dash their hopes. Or even in psychiatry, the distress of a patient’s mental illness and impact on his or her quality of life and that of the family and yet every intervention you are trying does not seem to be working, or the patient becomes so hopeless that he or she commits suicide. In civil engineering you must be accurate with calculations to prevent mistakes, sometimes fatal. But how much time do you have to check those calculations? Much longer than some physicians have to make split second life or death decisions. And with each patient, the variables keep changing- age, state of health, family history, family environment, compliance with treatment etc.

    And yes, your girlfriend will continue to research ad design life-saving tools. But a physician must decide on a case-by-case basis when to use those toolsm while being aware of other modalities of management that are available- without the physician, her tools are useless. You make it sounda as though the physician is just a monkey trained to use a tool. And as someone said, if the tool is unique, she can patent and make more money than most physicians.

  124. 125. cjojay

    At the end of the day medicine DOES pay well- you will be earning more than most of the population. However, there are faster and easier ways to earn MORE.

  125. 126. robert

    you can earn way more than that i am a doctor an di make 700k a year or sometimes more

  126. 127. raj

    To the topic of overhead fees, most doctors and clinics will show high over head cost, to reduce the amount of income tax that will be deducted and off course they aren’t going to be getting that income tax back, so overhead cost will show up to a point of 33%. Off course saying this out of bloom, with out any research or proof or resource, would not be valid, but think again, they have accountants and finance advisors most of the time working to maximize profits by every means. Next thing, a GP or even specialist, will have range of salaries, only if there is a business aspect to it, meaning Independent practice rather than just working for city hospital, acting adviser and consultation, novelist, or tv show host, and so many more ideas, along with your MD degree can earn you alot. Also increased salaries and wide range depends on where you practice.
    Lastly, do not be discouraged by the aspect of decade worth education, or 200K debt, and following all that a low paid practice, because its in your control how much you want to earn, question is not how much you can earn, rather if how much you want to earn? then next question, which profession is worthy of your intelligence, and something you like. For example, Micheal Jordan famous basketball player, if he had been a doctor, may not have been as successful as he is now. Fame, wealth, and recognition. So what is it that you are good in, and go in that direction, cause thats the password to your million dollar account.

  127. 128. Dutch

    Funny thing, how people talk about slave wages for interns.. I’m from Holland and my friend who just graduated medical school there (6 years) had 50 hour work weeks as an intern and a take home wage of about 30 Euros a day (about 40 bucks).. Internships are not subject to minimal wage there.. Then again, total tuition cost for those six years was 9,000 Euros, or about 12,000 dollars Canadian.. What her eventual salary will be I don’t know, our doctors don’t seem to talk about that during consults.. ;)

  128. 129. merle

    im afraid i won’t have a good enough for why i want to be a doctor when they ask…for those who were accepted recently, what did you say during your interviews to impress them?

  129. 130. ashamed ex canadian

    So that’s what high paid doctors in Canada say to themselves to feel better? That they deserved high salaries because they save lives? That they don’t do it for the money but the passion? I must admit that I heard twisted fairy tales in my life, but this one beats them all. I save around 50 lives per week in my third world country (you know those easily preventable death you may have heard of: extreme poverty, malnutrition, malaria) with about 300$ worth of supplies… I must have missed the economic class where it says that I had to get paid for the lives I save! Even more ridiculous, I spend the extra part of my salary to save more lives… now I feel stupid. So, if I get that right, I save people life so it has to pay out… cash (because my feeling of well being, of doing the right thing is not, of course, payment enough) so how much should I get for those 50 lives? I know, it’s not the same quality of life as the one you are saving (obese, smoker, drunkard, polluter), but third world country subsistence farmers (you know that guy that works for 2$ a day to send you fresh bananas) but still it has to be worth something? The foundation of saving lives is therefore not because I CAN but because I CASH, that’s the great mystery of life that has been eluding me for so long!!! In all seriousness, any person tied to health care profession complaining about the remuneration of their work shouldn’t be a physician (and they are generally those bad ones). If there is one profession that should be ALL about the calling, it is this one. Money should never come in play for those persons. Their studies should be free, they should be given houses, cars and all their primary necessities and a very insignificant amount of spending money for they should be our modern day saints giving all for others for the benefits of humanity not for a profit! I deeply hope I was able to create some shame for some of you and to rethink the role of physicians in a society.

  130. 131. Intrigued Doc

    @ashamed ex canadian:

    I don’t normally write on these blogs, but your comments pointed out a number of things that I find are interesting to discuss.

    To clarify my background both my wife and I are physicians working in Canada who also have volunteered in third world countries, as well as worked in the third world areas of our country (ie. Reserves and some areas of the North that have no running water and shacks for homes)

    I am going to take a guess by your comments that you would describe yourself as a strong believer in socialism promoting equality in income, health care and the general standard of living on the whole for a nation’s population or the general pursuit of these ideals. I myself came from a strong socialist background belief until recent years.

    To your first point of saving lives on minimal income with minimal compensation I first want to commend you on a noble endeavor that the world certainly needs. These countries with poor economic means would certainly be worse off if not for volunteers and foreign aid. I think you need to be careful when comparing saving so called defenseless lives secondary to being born into a poor nation, to those born in a wealthy nation having health issues that are largely self-induced (obesity, smoking, drug and alcohol addiction to name a few) I find it rare that someone would hold one life to be of greater value than another – certainly if your family or friends were ill I’m sure you would be happy to have expensive technology and medicine as an aid to improve their chances of returning to health!

    To your point of physicians shouldn’t be concerned with their remuneration and should in fact be paid less and as a whole be the modern day saints of our society also brings an interesting point. We will have to assume you imply this to be in the context of Canada’s current mixed capitalism/socialist system and not one of communist ideal where all professions operate on the same ideal for the basic requirements of standard of living.
    If indeed doctors made the same as say teachers or nurses who also are paid through government wage, lets contemplate what would evolve. I don’t think anyone would debate that it doesn’t require more time/ personal effort to become trained as a physician rather than a nurse or a teacher. Comparing the number of years alone, to become a nurse/teacher is approximately in the range of 5-6 years while a physician takes a minimum of 10 to be out and practicing as a GP, while the median would likely be 13-14 as most people don’t get in straight out of undergrad or they do additional training. I would also submit that the number of hours spent studying/ job training is vastly greater without trying to specify amounts. Additionally, the cost of schooling is obviously higher. This analysis holds true comparing to essentially all other careers out there – anybody that knows of a equivalent field requiring a similar # of years/hours/expense please advise.

    Now people fail to realize that doctors aren’t inherently all brilliant people that were simply born with the ability to absorb a copious amount of material and practice medicine. The key feature inherent in all doctors (whether good or bad physicians) was the ability to delay gratification in the face of enormous personal effort and for the majority also a significant financial burden. Whether that gratification comes from ensuring financial freedom/security for their family, materialistic desires, or for the so called love of humanity and complete self sacrifice for the common good – this delaying of gratification for the belief that all that effort will lead to fulfillment of that personal desire is essential.

    First, do you believe that ideally there are a sufficient number of physicians that would endure the above process for the “modern saint” ideal? Would there continue to be growing numbers of them in the face of a Canadian doctor shortage? Would they continue to sacrifice greater numbers of hours away from the families than the average person in the workforce to hold to their idealism? Would they not hold some resentment to some of their fellow countrymen around them who enjoy a better standard of living without dedicating an equivalent to the greater societal common good?

    I suppose society could just decrease the amount of effort it takes to receive the MD designation and then more good hearted people such as yourself could be in Canada saving lives here too for “the modern saint” idealism. Yet with physicians making mistakes despite high levels of training in physicians and deep competition to get into medical school, I think I’d rather have the money-grubbing, Ferrari-driving materialist that waited 15 years to obtain it opening up my chest rather than your whole hearted goodness that leaves me dead on the table.

  131. 132. ashamed ex-canadian

    @Intrigued Doc

    First I’ll admit that I did suffer from some utopist delusion which died off quickly after I moved away from Canada 12 years ago. The harsh reality of the life in third world countries somehow quickly brings you back to reality. I understood that the lifestyle of rich countries was tied to the exploitation of the poorest countries (or should I dare say slavery!). The system as a whole is bound to fail the moment that people paid a dollar a day to work 12 hours (mainly China) would rebel. When you understand that, you see things on a different light. No wonder they say ignorance is bliss. When you don’t see the suffering your lifestyle brings to others, it’s easier to make yourself believe that you’re a good person.

    To address your first assumption (socialist), I would say that I was rather brought up quite capitalistically and would still say that each person deserve according to their effort. Where I cannot agree is the lack of control of the capitalist system. I would therefore, agree on a controlled-capitalism which would limit the benefits of one’s work to let say 100%! Example, if a t-shirt real cost until sold is 5$ (taking all costs into account), the maximum resale price would be 10$. However, when it comes to the intrinsic needs of a society as whole, money shouldn’t be a motivation. You are right to assume that physicians wouldn’t be the only ones included in the social programs. Law enforcement, civil protection, government would fall under the same kind of rule. Here, is a very good example in Canada, of underpaid social workers: police officers. I’m pretty much convinced that no one in Canada becomes a policeman for the salary or benefits offered (maybe for the “power” of the position).

    The main point to understand in what I suggest is that education and your basic needs during the time of your education would be provided by the state. So money would never be an obstacle or a motivation toward entering the medical career. Do I believe that in that context there would be sufficient physicians? I’ll take here an example which I do not endorse but shows nevertheless a result. Cuba has the second highest doctor-to-patient ratio in the world after Italy and the best health-care system in Latin America. (ref. http://en.wikipedia.org/wiki/Healthcare_in_Cuba) A good education system to begin with is a strong tool toward forming future professionals and when money is not a concern anymore, anyone willing and capable will be able to study. So the only real thing left to create is a real sense of compassion and empathy for others. Also of importance to note, a more educated society should need much less of the cares of physicians, (less smokers, drinkers and food related diseases) accidents would be the primary source of work.

    I would go as far as to say that, the work load of physicians should be less than the common men (the current rate of work in Canada is deplorable), more frequent vacations, so that he would never feel used by society and would be happy to give back. Don’t worry, I do intend to write a model proposition on that since, believe it or not, I call myself a writer and a philosopher (but being Quebecois my English writing skill might not seem up to the task but I do pretty well in French!) I took that decision recently, when I remembered what my father used to tell me: “Do not ask yourself what the community do for you but what can you do for the community”! You can guess he was just trying to get me to help some more around the house, but I can now see a greater truth to it. As much as I did to change the personal life of some people I never did anything to change the society or even tried. Therefore I decided it was my duty to try (as a detractor of the present system); my first paper will be about the true value of a profound health reform. So at least now, if I ever succeed, you will know who the one to hate is! ;) I always welcome further comments to help me see the other side of the fence. As a final parenthesis, another thing I find totally abnormal, is to see medical professionals smoking, obese (or leaning toward), abusing drugs (often prescribed ones). Which security can you feel in the hands of such a person? A care-giver who doesn’t care about himself shouldn’t be practicing. That only shows you the decadence of the system (health that is) who allows it.

  132. 133. plancker212

    @ Ashamed Ex-Canadian
    I completely concur with your thoughts. While l am not a doctor but a professional engineer working with the oil sector, I do tend to keep my knowledge and curiosity alive with-in the ‘practical’ medical field through reading and research.

    I do agree with you on the fact that passion is something that is required in any profession to be the best out there and to justice to the profession. It is wisely said that ‘One man with a passion is much better than 40 men merely interested’. This I do not see in many doctors in Canada (at least not professionally and with-in the Canadian medical system,in my personal experience) though I could be wrong, I still believe many practice the profession for the material benefits as opposed to the passion to cure and rid the patient of his or her suffering. While there are a handful doctors who are very good at what they do, many of them are worried about compensation as opposed to patient health. I think the whole process (of materializum and a capitalistic approach) starts of at the university, with high cost to fund medical program and carries over to many medical practitioners talking about compensation to balance the time and effort spent in school.

    Anyhow good discussion and while its hard to change the thinking process and end world hunger. We can all acknowledge that medicine (or any other professional career) should be pursed for passion and then worry about the money to help survive in an ever increasing material world.

  133. 134. engineerincanada

    To all of you who think that engineers don’t have to make split-second decisions that affect lives – let me tell you a bit about that. I’m an operations as well as a design engineer specializing in control systems. True, design engineers do not need to make many split second decisions – When I do my design I re-do my calcs a few times, consult with coleagues, etc and by the time I put my signature on the drawings I generally sleep well knowing that chances are fairly slim that whatever I designed will blow up one day. Operations is a different story though. During the “start up” or “comissioning”, you literally have minutes to make sure that whatever you are doing – works. Just imagine – the whole plant is simulated on your computer and you’re working on it “live”. People are screaming at you. Things are often not working. You’re at your computer trying to make them work and under terrible stress and your job is on the line. If you were to press one wrong button on the keyboard you can open/close a wrong valve, stop/start a wrong motor, long story short, make the whole place blow up in seconds. 1000+ lives gone, including yours. How is that for responsibility? Just my 2 cents, thanks for listening.

  134. 135. Chinstrap

    For those interested in the original topic about what MDs make or can make.

    This summer in Ontario there is a gov’t assisted initiative to get physicians to do shifts and help out in rural Emergency departments (Southhampton, Woodstock, Goderich, Tillsonburg, for ex.).

    The pay is between $110 to $140/hour (depending on day/night) plus a percentage of billings which can add up to another $1000 for an 8hr shift. So for an 8 hour ER shift one can make about $2000 depending on the volume and acuity of patients seen.

  135. 136. engimaoflife

    Simple reason behind all these issues – ‘Supply and Demand’…Doctors and lawyers are paid highly in the North American system simply because of this reason. Look at a third world country and the Doctor is simliar to an Engineer a Lawyer much poorly compenseted than both the other professions.

    Doctors enjoy memorizing (I can use my little WebMD on iphone) to look up medications and have a fair idea of what these medications are doing to the body etc. The engineering eduction/skill draws more on creativity and less memorization. It is hard for me to find the same problem many times with-in the engineering field and many times the problems are very different and unique. Yet to come up with a program or database where I can punch an engineering problem and it will give me the solution which will fit the issue close to prefect…..Anyhow again boils down to supply and demand. The prestiage part of the profession, well everyone knows what a doctor does or what a lawyer does, but not many folks know what engineering is all about unless they are involved in the field….!

  136. I am really surprised to know this. I am specialist orthopedic surgeon practicing in India having my own orthopedic hospital. Even by earning in Indian rupees [CAD $ = 46 Rupees], I save more than 120K CAD $ annually after paying up all overheads, staff salaries,Income tax and house expenses. One would wonder to know that I have been trying to get work in the Canadian healthcare system in orthopedic surgery for last three years- mind you not for money BUT family reunion as my son is in Canada. I am not getting any good position. I have cleared the required examinations. Twice I have undergone the evaluation by prestigious CEHPEA in Toronto and passed the evaluation as orthopedic surgeon both the times [in 2008 and 2010]. I am in receipt of Eligibility letter for provisional license in orthopedic surgery in province of Alberta, I am still without a position. SO I have stayed back in India. Of course I love my subject orthopedic surgery as much as I love my family.
    Reading this I must say Thank God that I did not choose anything else [other than becoming orthopedic specialist] in healthcare system of Canada to be with my son! I would have been at a bigger loss than I would have expected ever since I have to support my son for his studies in Canada!! I am proud to say that even after earning in India I can support my son fully for studies in Canada.

  137. 138. Chinstrap

    I made a mistake. The rural hospitals are offering more like $180/hr and higher depending on shift. For example, one hospital near London On. is offering $220/hr for a 4pm-12pm shift on a long weekend plus a % of billings from OHIP. If you work the actual Holiday, say Labour Day Monday then it’s even more. If you live in Toronto or 2+ hrs and have to drive they will pay $300 per way to drive.

    In total for a 8hr locus shift on a holiday weekend, it’s $1760 + $600 (drive from Toronto) + % of billings. Total of approx. $2700-$3000.

    A small town in NW Ontario ( near Minnesota border) is looking for a family doc, who can also do some ER call. Salary is $540,000 with no overhead as it’s covered and they have EMR (elec. medical rec.) so it’s easy to bill. This does not include a signing bonus if you sign to stay for 2 years, 3 years, etc. This could be $75000, $150,000 or more depending on how long you say you will stay in moose country. They also pay for a locum to cover 37 days of your vacation.

  138. 139. Markus

    I find the comments made by people who are Phds and engineers etc are highly misinformed. They have no conception of how difficult it is to become a doctor. They must think,”oh I have a hard degree, I am just as smart”. When you get into med school its at another level. You are competing with the top 5% from undergrad that are now your peers. The standards and expectations are super high. You don’t stand out just by being smarter than average. If you are lucky enough to get into a competitive specialty you spend either long hours on call or long hours studying. It isn’t “oh I have to cram” 1 week before the exam study. It’s lock yourself indoors for years study. And its over a decade of studying! The social isolation and lifestyle is appalling. It wrecks relationships. Then there is the stress of going over 200k in debt and not being able to make payments on it while you are working over 80hours a week for 50k salary for years of residency.

    Although some Phds have a difficult topic, I have never seen one work that hard. They get paid a stipend and actually make money while they are doing their degree and most can live normal lives and have relationships. Most of my friends are engineers and they all were able to start families, buy houses go traveling and enjoy life up to as much as 7 years earlier than my doctor friends.

    I went to chiropractic school. I, like a Phd can call myself a doctor but have no misconception that I have worked as hard or been through as much stress as having gone to med school and residency. From my point of view, people just simply don’t value health care (and health) enough. I am young, fit and in optimum health but when I am over 70 and want to keep going I want there to be someone I can count on.

    I think that we need a pension plan for doctors similar to countries in Europe. It would allow for a little bit of that financial stress to be relieved. Also there should be some tax break or interest freeze on the tuition. If the simple economics of the profession make it so that a plumber investing conservatively is worth more at 75 than a doctor this needs to be addressed. Otherwise, it will no longer be the top 5% going to medschool, you will see a changes in the quality of service and then realize just how much health care actually is worth.

  139. 140. FM Specialist

    Family medicine is very underrated as a career choice among med students. I did a 2-year FM residency and my gross income last year was over$700k – higher than any specialist I am aware of … just food for thought.

  140. 141. Chinstrap

    FM Specialist, can you elaborate a bit for us on how you made the $700k.. Are you in a Family Health Network? Do you do OB, ER or anything else on the side? Did you sign up for a rural incentive placement program? If you could elaborate it would add believability to your comment and frankly my spouse in interested (she’s the new doc)

  141. 142. Engineer

    I am an engineer. I’d like to resolve any doubts as far as the comparison between physicians and engineers or scientists are concerned.

    Any profession that demands knowledge in higher mathematics like engineers, actuaries, physicists is a lot more intellectually demanding than physicians’ job.

    Med school students are just memorizing a whole lot of material. While I do agree that medical students spend more time learning by heart they are not even close to being as creative as engineers are.
    It takes only willpower and being hard-working to complete (or rather cram through) MD. It doesn’t involve any aptitude.

    I think only people, who work in a profession like portfolio management, semiconductor physics, computer science will appreciate my post to the fullest. To succeed in any such field you have to be a math and physics whiz form high school and then excel further in university.
    I know many medical students. None of them would be able to understand differential equations. They would just memorize how to solve them without understanding. It’s also true that many engineering students do not understand them, but those do not succeed in the field in engineering. The people who understand differential equations end up doing jobs like designing new aircrafts and I do believe such jobs are the most inspiring.

  142. 143. Chinstrap

    Engineer,
    It’s funny how people classify themselves. “I am an engineer, or I am a doctor.” Is there really a need to box anyone in? Although there are generalities and stereotypes people make but we know that doesn’t solve or prove anything. It’s all in the individual and then facts.

    There are engineers who go back to med school and doctors who leave the hospital bureaucracy and grind to try consulting, the corporate Pharma world, etc.

    Turning to facts… An Emerg Doc can make $500k gross and incorporate to lower taxes. An engineer at Apple or Facebook can make millions b/c they get options and bonuses for designing the leading edge new apps.

    Vice versa, you can get a family doc working in a community health clinic which pays only $125k but they enjoy the work. And you have engineers that walk around working for the city checking to make sure the sewer pumps are working… that doesn’t take differential equations to me.

  143. 144. frugaldoc

    Engineer,

    As a person who did a physics degree before med school, I can appreciate your post. I, like you, have a high aptitude for math and find it easy to understand differential equations and such. I also think it’s more intellectually demanding and interesting that memorizing crap, such as medical things. I was drawn more to the interactions with patients and other health care team members, as well as the high pressure situations in emergency medicine. This trumped the superior intellectual satisfaction of physics.

    But I have two counterpoints. One is: so what? Does anyone really care that it is more intellectually demanding to be an engineer, other than engineers. Probably not.

    The other one would be that the model for physicians, in North America at least, isn’t one where the challenge is med school itself. It’s getting in. One does have to show a great degree of aptitude and determination to get in. The rare person who fails or quits usually does so because of personal issues rather than not being able to complete the work. That doesn’t mean everyone has the option to do med school if they want to. At the same time, the stereotype that doctors simply memorize a large volume of information is becoming increasingly less accurate. The amount of material to know is ever increasing, and the tools available for rapid access to resources for looking up information are continually improving. My point is that the current generation is less memorization dependent. It’s more about how to effectively find the correct information and critically interpret it for the situation at hard. I really only memorize the things I need to know immediately for true life or death situations.

  144. 145. SST

    @Engineer: “…I do believe such jobs [designing new aircrafts] are the most inspiring.”

    Maybe, but only for engineers.
    I’m sure there are plenty of teachers out there who think their jobs are the most inspiring. What’s more inspiring — building better things or building better people?

    @frugaldoc: “…so what? Does anyone really care that it is more intellectually demanding to be an engineer, other than engineers. Probably not.”

    Bingo.

    Then go ask Buffett if he understands differential equations and if his intellectual “inferiority” lessens his wealth any.

  145. 146. Undecided

    I have just graduated Highschool in Canada and around here there is a high Indian population. Being Indian myself I know a lot of students whose parents are sending them to medical school in India because there one goes into the 4 year med program right away no under grad is required. After residence they come back to Canada and do their specialty here. However seeing how many are flocking to India for this it makes me wonder if there will be an over supply of doctors especially in the states more and more foreign Indian doctors are getting hired. By no means am I targeting Indian doctors but rather after there being a shortage of doctors for so long and now thousands of students studying medicine abroad is it possible there soon will be an over supply?

  146. 147. medstudent

    Interesting to see this comment section still going.
    Doctors are paid fairly I believe, but certainly aren’t swimming in it.

    In Ontario, you need at least 3 years of undergraduate to enter medical school, (maybe 5% of successful applicants), the majority will have 4+ years of undergraduate education prior to medicine.

    You do 4 years of unpaid schooling in medicine (8 months of a 700 stipend in your 4th year)
    and then 2-7 years of residency making 45-75k gross a year (incrementally increases year by year) while working generally wild hours.

    I started univ at 19 did 6 years of undergraduate, needed an off year to reapply. Will have done 4 years of medical school. I will be 30 before I earn my first cent in medicine, and the average medical student will carry nearly 200k in debt, some more.

    I will be 32-37 before I earn anything close to the figures pointed out in the above article.

    At that point, yes I will be paid very well and have excellent job security based on my specialty/area of medicine. But it will have taken me 12-17 years of training to get there. I will have delayed having children, home ownership and many other life milestones to get there.

    I’ve never regretted my choice, and love medicine. However, remember when you think a physician is overpaid or very well off, it was a long path of long hours and training to get to a point considered comfortable and you have to do it because you love it. All the money won’t make the decade of training enjoyable if you’re not into it.

  147. 148. SST

    Who do you think is worth more: a doctor or an investment banker?

    According to income levels, it’s the banker.
    But let’s see how far society would get without doctors.

    Just something to think about… :)

  148. 149. Jack

    I work in the HR department for a large medical center in Kansas City. The absolute minimum salary we will pay to a general practitioner just out of residency with no specialty is 165,000. With 10 years experience, this same doctor will be paid between 190-205. Obviously pay for specialists varies. What I can tell you aspiring physicians is that we just finalized a contract with an orthopedic sugeon who will be paid 385,000 per year. Upon signing he received a 12.5% bonus (damn!). He will be given a raise and possibly another bonus every two years. Generally, surgeons make by far the most money. Get into neurology or some type of vital cardiac surgery and you could make over 1 million dollars in a year. Dermatologist can make a killing too.

  149. 150. MI Resident

    My take on this entire issue is that we became doctors / physicians to help people and not to earn the highest income in the country.

    You really have to be an idiot to spend 5-6 years in medical school + intense pre – medical school preparation + 4 to 8 years of residency & fellowship + huge debt + stress full lifestyle with thinking of earning higher then other professions. There are so many other ways of making decent money but this is what distinguishes a physician from others … to help the sick and save lives.

    Now I am a general surgery trainee in USA and I have full right of complaining about compensation in general surgery when you compare it to the long working hours, poor quality of life and law suits on top of that but then i tell myself that I choose to do what I am doing and I knew very well how my life is going to be.

    For me the most frustrating thing is the difference in compensation between different specialties and sub specialties in Medicine and Surgery. I could not believe my eyes when i saw that for a heart transplant a CT surgeon is making 4000 $ including post op ICU / floor care and fup visits upto 90 days (yes this is what a CT surgeon makes !!! ). Now compare that to fixing 2 hip joints or even putting 2 Laparoscopic gastric band procedures (obesity surgery). These are going to be compensated the same as a heart transplant with probably 1/3 the stress, time and complexity. Also compare that Orthopods and interventional radiologists are making the same (around 400K-600K) so do poor psychiatrists / pediatricians and anesthesia NURSES in USA (130-160 K) which i think is insane.

    My point is people complain when they feel being exploited. There is so much discrimination in salary with in medical specialties and sub specialties let alone medicine and other professions.

    Bottom line is
    1. Do you home work before choosing a profession and once you are in that profession stop complaining.
    2. Govt should take steps for decreasing the discrimination in compensation between professions and with in a profession because insurance companies will not.
    3. Stay happy with what you do and earn. Money has no limit neither does it gives you happiness.

    All the best.

  150. 151. Ghaz

    Anyone know how to become a ER DOC on the front lines?

  151. 152. Daniel

    Dear everyone.
    So, you like questioning other profession making too high of a salary. Would you like to do that job or being in their shoes? I tell you the truth, I would not because it may not make me happy, doesn’t matter how much it pays.
    The reason I came cross this site is to know how much a graduated profession would be making after so much $$$, times and health line invested and still have to work long hours afterward with great responsibilities. As I have found out, I have full respect for them but I would not trade what I have been doing in my life.
    I have been just a jack of all trades and master of none at the age of 55. I have done many things in life and allways being good at it. My idea of successfull is being able to do what I like. As I have fullfilled myself with some education, traveled twice around the world, and only worked as little as I have time for it at work that I like to do. What I allways like to do are things others don’t want to do or can not do; and of course money that comes with it is like academic point system to rate the achievements.
    Last 2 years I paid as much as a Phd would for his years of education. I am graduated gambler now. Without holding a degree, my wage is at $1000.00/Hr easily guaranteed, no over head and tax free. Yet I’ve decided to only allows myself 1.5 to 2Hrs of work/day so I can enjoy the rest of the day with something else that more worthwhile for life which I like to do better than just making money/ being greedy.
    I’d say we are all deserved what we are doing, including being complainned (with full respect). It is obvious that as we read and write these comments are also what we like but don’t let it gets to you. Try to measure happiness from what you do then you will see the wisdom. This includes making changes to make you happier. This will apply to all aspects of life.
    KNOWING YOURSELF WILL GIVE YOU SUCCESS and
    REGCOGNISE YOUR GREEDINESS WILL GIVE YOU HAPPINESS
    Good luck to you all.
    Daniel

  152. 153. C'est What!

    Take Daniel’s opinion seriously… that post will have costed him roughly $500 in earning potential… haha.

  153. 154. Pickles

    I have read some of these comments, and found them to be obscenely naive.

    Do you ever wonder why North American doctors (the U.S. especially) have such high salaries?

    Doctors in Japan earn about 1/3 less than American doctors on average ($15,000 a month for Americans), have longer work hours, and arguably the same quality of education. And what about a doctor from an undeveloped nation, like Kenya? Forget about it.

    So what’s the secret to the success of American doctors? Let’s just say, that it’s a kind of safety net. The creation of organizations, such as the American Medical Association, ensure that doctors will always be a profession in demand, and that it will entail lucrative pay.

    Have you ever wondered why there always seems to be a shortage of doctors? It’s not from the lack of people interested in medicine, it’s simply a limit created by the AMA to always keep doctors in high demand. And the less doctors, the more likely people are to have some affliction. And bottlenecking an essential service is the best business tactic one can use- but definitely not for the customer.

    But how do they set the limit? That’s easy- they make everything hard. Medicine inherently is not an attractive career option- not very many people have the commitment, dedication, or passion for such a calling. That’s when they have to sell M.Ds, by creating strict admission guidelines, expensive tuition costs, and limited seating for medical schools. Things like the mcat are introduced to add further pressure to would-be applicants, and more coin for the organisation’s wallets. Application is an expensive process! Suddenly, medicine becomes prestigious. The debt is only a temporary issue- as soon as a newly-licensed doctor starts to roll in the big bucks, their debt is slowly cleared. It’s like a wholesome pyramid scheme!

    Most other countries, by comparison, treat medicine as a trade, and not as an elite position of which you can have incredible influence. No, just another cog in the health care machine. And that is the blunt reality of medicine- being a doctor is a kind of trade, you apply contemporary science to find a practical solution to a person’s problem. Theorizing and solving mysteries is left to the drawing board. Isn’t it funny how people who were doctors in other countries end up driving taxi cabs in North America? Do you think that the AMA hands out licenses by the bundle, just to solve the doctor shortage issue in America? Fat chance. The situation isn’t going to get better, the amount of doctors are only increased to reflect population changes, nothing more.

    Add to that, the intimate relationships with the pharmaceutical companies, and other questionable industry, and you’ve got a match made in corporate heaven. Doctors get all sorts of neat things from these companies, only if they play by their rules. And they can only play by their rules, otherwise, the doctor’s licenses go through the shredder and they are out on the street with nothing but their stethoscopes. Drug safety, ethics… Who cares, when it comes to money.

    So what do we do about this? I’m not sure, I’m afraid. It’s clear that the doctor shortage isn’t going away anytime soon. To people who hope to get into medical school, but probably aren’t in the best situation now: slow down. There’s a lot of responsibility that comes with becoming a doctor, and going in head first will make you another brick in the wall. There is so much to consider, that we must take a cautious approach to such things.

    As to the issue of doctor salaries… Let’s just say I’ve never heard of a doctor who has up to their neck in debt, unless they were really bad doctors. There is always more money available for doctors- such as becoming a shill for a drug company or some ‘health’ product.

    Without the high prestige we have for doctors, they wouldn’t earn as much. I’m sure doctors deserve quite a bit of compensation for their work and sacrifice. But in this case, I doubt the Hippocratic oath would condone making money at the expense of others.

  154. 155. GT3 RS

    25 yr old high end restaurant owner. Apprx. 100hrs week.

    I see professional day in and day out. I respect all those who genuinely love their job. They attend several seminars to further their education in my establishment and most genuinely work around the same hours as I do. They deserve every penny they make and then some especially seeing and hearing their stories on a daily basis.

    The only issue I have with several doctors is that they are generally socially challenged for the most part. Luckily most of them are specialist and have very little need to talk to people thankfully. But A family doctor with no people skills deserves 10$ after tax.

    As far as restaurant business income, it’s high to say the least, assuming your not 1 of the thousands that fail day in and day out for those who think it’s easy.

    Do what you love in the end. I respect all those who do. But those working for the public who are unable to have a “human” conversation should not be doctors just because they can regurgitate useless undergrad information just as I did for Biology for 4 years or university.

  155. 156. Herniated

    I just wanted to add that I think Pickles is quite right as to why physicians are overpaid in this country. It is a tight linked organization that protects it’s interests well. And that interest is not the public health. There are many major overhauls that would be needed to have a society actually based on people’s well being. And making physicians a job like any other rather than a position of prestige and power would be one of them.

    In the meantime, I have this society to thank for the 700k I inherited from my dead mothers assets and life insurance, at the age of 28. Making my valuation at the time 800k. Since then I have grown it to 1.1 million and have just turned 31. I have roughly 1.7M in rental property with .75M in mortgages. And 200K in stock with 35k on margin, with the debt being in USD of course, exchanged at 1.05125 USD/CAD. I made 60k off my investments last year (I don’t work), and paid 2k in taxes using depreciation on my properties. I spend less than 15k a year. And that includes my car payments which is for the business and thus a write off. In fact I try to spend less than that, choosing to live at relatives who charge me low rent or going as far as not heating when I stay in apartments that I rent. And try to invest 5k a month after paying off my mortgages. In order to grow my earnings by 10% a year when you include rental increases. Money has not given me happiness and never will. I live this life which I am not really proud of in order to achieve my ultimate goal. Which is to have a profound impact on the world. I would not trade my million to be a doctor, even if I know such an investment would be financial wise. Sometimes I envy the prestige, salary they make, and mostly the possibility of having both while saving/helping lives. However, I do not believe doctors help people at all. And in fact, partly because of their high salary, and partly because they have a direct interest in playing along with a band-aid health care system, are on the problem causing side of the scale when it comes to human equality and well being, not on the solution side.

  156. 157. Herniated

    My first post was unsuccessful. Here is what I recall saying:

    I believe physicians are greatly overpaid. Much like the new crime bill can be compared to an expensive band-aid which tries, mostly unsuccessfully and often temporarily, to fix a problem. When a preventative approach would be much more cost efficient. Especially when the biggest contributors to crime, drug addiction and poverty, could be greatly reduced with a fraction of the budget the band-aid solution will cost. And the savings are even greater as you don’t throw members who could contribute to society in jail where they do nothing but cost us all money while rendering no services. That is without mentioning the human element which obviously makes inprisonment of individuals less attractive than investment in their well being. The same thing can be said about doctors and our health system. Rather than invest on prevention we prefer to pay greatly for a band-aid solution. And so, instead of investing in prevention and people’s well being as they develop. Which would gives us a healthy population. We prefer to spend enormous amounts of money on providing people with a few more years or some level of relief once the problem has occurred. And this, with the help of costly surgeries and drugs which have many detrimental side effects. When prevention has only one side effect, a higher level of well being. One only has the look at heart disease for proof of this phenomenon. The very fact that a case of malnutrition is considered a disease is very telling of our health care approach. This ‘disease’ has been a cash cow for health care for many years, when it’s prevention is simple. And when, for many years, the government has been a cause of this ‘disease’ through its subsidization of meat and dairy products.

    The truth is, just as a plumber has a undeniable interest in your plumbing having problems. So does a doctor have an interest in your health having problems. With 500k, one could make much greater impacts on peoples health by investing in their well being, than by paying one physician to deal with their ailments once they can no longer be prevented.

    I have met many incompetent doctors in my life as well as very good ones. I am both grateful towards them as I am displeased with some of them. My mother went to doctors for 1.5 years to determine the cause of her intense heart burn. Somehow her cancer was not detected until it had reached the liver and she had but a month to live. Truthfully, I am glad she was not subjected to the expensive treatments that may not have even given her a good quality of life. Some would say there is no price tag for any extra time but is it really worth hundred of thousands to extend someone’s life? Especially when this extension is often an agonizing one. Perhaps it is worth the cost, but it certainly does not compare to the preventative measures she could have taken. Which may have in fact been free and would have given her a higher quality of life. Namely, vegetarianism which would have immensely lowered her chances of having intestinal cancer in the first place.

  157. 158. Herniated

    BTW this site convinced me to use interactive brokers and I have never looked back since. It is by far the best and cheapest trading site. I keep a small portion of stock in an RBC direct investing account as well and sometimes
    appreciate their format and free info and reports.

    For your entertainment, this is my present portfolio:
    2 500
    330 300
    941 500
    AO1 120
    Av. 600
    AZN 60
    BAM.PR.T 100
    BBD.PR.B 100
    BCE 300
    BLND 300
    BNA.PR.C 100
    BMO 148
    CAS 519
    CM 180
    CSCO 100
    CSGN 60
    CTU.A 600
    CTY 160
    DDIC 100
    DGE 100
    DII.B 200
    DL 200
    DRX. 300
    EBF 100
    GSK 190
    HPQ 200
    INTC 100
    JNJ 100
    KO 50
    KPN 800
    MEDIQ 100
    MRK 101
    MIC 200
    MKS 500
    MRW 425
    MSFT 230
    NA 30
    NGT 388
    NOVN 45
    POW 100
    PWF 100
    ROG 20
    S 300
    SCMN 5
    SL. 1000
    SLF 100
    SSE 100
    AT&T 306
    TPK 700
    TSCO 300
    VOD 1400
    WB 100
    WJX 100
    YLO 300

    IN TFSA:
    5K GIC 3.5%
    DRX 4000

    IN RRSP:
    ORA 800

    All of the stocks in my taxable portfolio pay dividends, or at least did when I bought them. As you can see, I take risky bets in my RRSP, which I will no longer contribute to as my tax rate is too low. I will just bank more contribution space for later. I search for stocks that are selling under book value without counting goodwill, and have very little debt, for my TFSA. I think it’s more important not to repeat mistakes than focus on victories in investing. Regrets: YLO: Never tell yourself ‘bah its just 1k’ and buy something you know is fishy. CTU.A and 3330: Why I decided to buy retail in a quasy recession, I will never understand. Av., DL, SL. and SLF: Although I don’t think these are that bad. It does seem that insurance companies are presently having a hard time generating enough investment return. However long term elements, namely extended life expectancy still makes them attractive in the long term. CSGN: Never buy simply to diversify. I knew I should have just bought more ROG to increase my Swiss dividends. Which BTW are subjected the worst withholding tax, 25% I believe maybe 20%. The others are 15% for my Dutch and US holdings. 0% for Hong Kong. And Canadian dividends actually lower my income tax by 3% of every dollar earned. I will no longer invest in other currencies, except in Hong Kong and perhaps dividend reinvestment. Not until my Canadian dividend income has reached at least 38k a year or the amount where under dividends are actually tax negative. This current portfolio produces over 8k in dividends a year (hard to know exactly how much since I keep adding and the companies increase.and decrease dividends) and costs me 500 USD in interest. I do not care whatsoever about capital gains and almost never sell.

    Like Graham said, you only invest for one thing: Dividends. Either paid to you at least once a year. Or paid to you when a company dissolves and that you had paid 66 cents for every dollar they had, giving a 50% return.

    Party on…

  158. 159. Herniated

    0% withholding tax for UK holdings as well. The edit comment button was not working for me.

  159. 160. Chinstrap

    Update to the original Comment about Doctor’s Salaries Not as High as You Think:

    Spouse doctor received an email for medical work this Holiday Season. Rural towns within 3 hrs drive from Toronto offering shifts.. nothing new. One very interesting one was a Northern Ontario town offering a Minimum of $2800/day plus percent of billings.. for about a 10 day period over the Holidays. They pay for your flight (and pay work time when you fly) and also put you up for the time there. So for under 2 weeks the pay is probably $35,000+

  160. 161. Julia

    Does anyone know the average debt that a medical school graduate has from loans?

  161. 162. med student

    ~180-200 k (can go higher)

  162. 163. The Dentist

    I have read the comments here. Some of which make no sense.

    Doctors and dentists have a very difficult job and can make a salary of between $150-up to $1m for the very best, which is good.

    However engineers may make $50-100k for an average engineer, but the best earn millions. Think cars, think Ford and Mercedes families. The patents on all the small inventions earn millions.

    Also, we all want to have the best healthcare. In order to attract some of the smartest people into medicine, lucrative salaries need to be offered. Sure, we will get doctors even if the salaries were mediocre, but I want my doctors that may one day save my life to be amongst the smartest people out there. Thats why pay needs to be high.

    If you want doctors to be average earners, they will be the ones with average grades. With my or my families life on the line, I’d rather have the smartest brains looking after us!

  163. 164. victor

    In Spain, an oncologist earns about 3.000 Euros net (hasn’t rised the salary for years), 37.5 hours/wk (plus 4 days/month working another 7 hours in the evening) in an Universitary hospital. I have a PhD, I am the tutor of residents, do research for free (most of time I have to do it at home because no time with the busy schedule) and 11 years experience after residence. I speak French and Italian quite well. I think we are the worst paid in the western countries. Do you find fair ?

  164. 165. leona

    well at the clinic I go to, my card gets scanned but most of the time I am seen by an intern with a strong accent, someone from abroad trying to get their credentials in Canada, and one of these students told me she was not being paid a penny by the clinic. So my GP pockets the money for the visit and gets free labour from these students from abroad. A bit of a scheme I think.

    I have respect for specialists, but my GP seems to have nearly disgust for the human body, and doesn’t even take my blood pressure. If he has to be involved with touching the human body, the student doctor from abroad does it, or I get sent to a specialist.

  165. 166. Financial Guy

    My company has a significant number of physicians and clients. Most of those physicians we work with are specialists.
    In Ontario, it’s not as bad as it used to be in terms of professional income; however they certainly are not overpaid. Most people would not even have a remote chance of getting into medical school far less completing it.
    In addition, they are dealing with situations that could have life changing effects if they are wrong.
    They are underpaid.

  166. 167. David

    Excellent thread and information. I would like to know of any doctors with arthritis. I am doing a second Bachelors to get in to medical school, but my ankylosing spondylitis is starting to get the better of me. I think that |I will need to reconsider my career choice as I imagine residency to involve much standing and walking.

  167. 168. DOS Master

    Reading this message board makes me feel better about my situation. I only have a high school education, but make $140 per hour as a consultant. Yes I did read DOS when I was in grade 6 and I have always been good with computers and people. I never wake up earlier than 10am and only show up to work once a week. Doctor’s have such a hard life, boo hoo.

  168. 169. SOmeone

    I believe salaries depend more perhaps on the person and their situation in general that decide how much they earn.

    Also, Ontario Physician and Ontario Engineer; its spelled divine….

  169. 170. Radiology is NOT a crutch

    At 33, my wife was earning 680K+ per year as a Radiologist in Canada. Her SALARY was 150k. Any Dr. earning more than 400K will incorporate to tax shield their earnings, and then claim (on their T1) a very LOW salary. This fact has not been taken into account. Your numbers are skewed because most Drs. making 400K+ will incorporate (if allowed) and then shield their earnings for later in life. (BTW, no pension, medical, etc means that you need to worry about your own old age, and this shielding of income is necessary).

    Typical scenario (I’ve seen this ***countless times***):

    2AM call from ER: 85+ patient with lower back pain. CT or MRI requested. 19 year old unresponsive (ghee, drunk maybe?). CT head/neck requested. And it goes on. The number of Drs not willing to do the most basic diagnosis is staggering. Imaging is the new Grey’s Anatomy. Many GPs are so poorly trained (or so busy) that they just blindly request imaging for almost anything. It is mind boggling. WHY, WHY is an MRI or CT being requested for ANYONE over the age of 80? It is absolutely insane!!! The patient won’t survive any surgery, and so what is the purpose? Expensive drugs to do what? Sigh.

    Cost to tax payers? A LOT. Fee-for-service is responsible for some very high salaries in Canada, not self referral.

    The truth is the following: my wife makes $0 (yep, identically ZERO. Yes, no salary, ZERO) unless someone requests imaging. Period. If she bills 1M per year, you had better look at the physicians doing the reqs, not the Drs doing **all** of the diagnosis.

  170. 171. Pac

    ^^^ Yes, well this is the trick isn’t it. The several physicians in my neighborhood are taking in $400-600K, a number of them have less than 5% overhead as they do work with hospitals and don’t have a private clinic, and their take home salaries are in the range of $120-150K.

    So that’s somewhere in the range of $250-450K a year not getting reported as salary, that can be invested, be called on later etc… Add to that that holidays can be tagged onto conferences and “educational” travel, some vehicle expenses can be written to the company etc… (also known as “overhead”), that even the crappiest doctors can bill these amounts and stand no possibility of losing their jobs, and it is the sweetest, least risky way to get wealthy in Canada

  171. 172. Am I ready for Med School

    I just spend 6 hours reading every comments on this page word for word and I would like to thank everyone for bringing an up front discussion to clear doubts in many head I would believe.

    @Chinstrap, if you don’t mind me asking and willing to help, I am turning 27 in about 2 months and I majored in Molecular Biochemistry, with Master in Immunology. Now I am trying to apply for med school and I will not give up until I get there. I am not a big spender, I will not spend my money toward fancy cars or house but just to make a living as my primary goal is to get my MD and being able to help as many people as I could. My girlfriend and I are engaged and we will marry soon, expecting little ones to pop out in the following years; however, as a Med Student, my ability to make a living is nearly zero and we understand we would have to cut down our expenses to get there. So my question is, at what age did your wife become a doctor? Would she be able to make it if the household income is under $80k / year? I just need to know this before I start med school as I rather save up and go for it than be forced to drop out due to financial issues. Thanks in advance for your respond and I do appreciate your time for helping me out :D

  172. 173. Chinstrap

    @ Am I ready for Med School

    Cool, so you did graduate work in immunology like my wife. As a med student the banks will shower you with credit lines. It was $150,000 professional degree (MD, dentist, etc) credit line which I hear is not $175,000 as banks like to get docs indebted to them years before they earn a cent. You can use this to carry you over or help pay tuition. I paid for my wife’s $20,000 tuition and it was even worse b/c I was working she didn’t qualify for OSAP and a lot of free money for ‘in need’ students. In the USA I am sure there are tons of scholarships for people who just deserve an aware w/o being poor… anyway,

    In the fourth year of med school, my wife’s school gave clerks $500 a month b/c they are actually on the floor doing work. When you become a resident you get a salary: around $550000 or $60000 depending on province and it slowly goes up. Oh ya, she became a doctor last summer at 33 after doing a 2 year residency. She is taking an extra year of training in Emerg. but she is fully qualified and has been doing locums in town and out of town.

    I don’t understand the $80k question exactly but when she was in school I was making $100k+ (but in Toronto which is not a lot) to help pay for her tuition and we didn’t take on ‘bad’ debt. Lots of her younger students didn’t have paying spouses and they make out.

    I would recommend saving up and then modestly using your credit lines and also get lots of awards. Don’t get married in your first year or two b/c then if your wife works you won’t qualify for most of the good paying scholarships.. again b/c the main cut off is does this person qualify for OSAP and then if so then they open up the awards to you.

  173. As a recently graduated specialist, I am 4 months into my first (and hopefully last) dream job, and thus feel I am qualified to offer some comments on this subject. I will preface this by acknowledging that I am one of the fortunate physicians that ended up practicing in their number 1 choice, albeit not my number 1 location (although that is changing)

    A bit of background:

    First of all when I graduated from high school, medicine wasn’t even a consideration. Like everyone else in my med class I graduated with the Governor General’s Bronze (top marks) in a graduating class of >500 students. I chose engineering and excelled completing the first year (in which 30% fail) with the second highest average. I contemplated a career in biomedical engineering (via mechanical engineering) and ultimately decided that I didn’t want to spend my life behind a computer screen and wanted some personal patient interaction, I wanted to make a difference in people’s lives. I also wanted to play with latest gadgets not design them. I’m not arguing which profession is more noble here, just stating the obvious fact that I had a choice between engineering and medicine and chose medicine.
    It wasn’t an ecconomical decision.

    For all the engineers out there who think doctors make too much money, first off I have a tremendous amount of respect for your profession. Are differential equations more mentally stimulating than regurgitating material for exams. Absolutely, which is why I transferred to science (pharmacology) to boost my entrance grades (one year was perfect, the others near perfect). I had to take some courses out of order (prereqs waived) but didn’t lose any years graduating in 4 years. And yes getting perfect grades in chemistry,biology,physics,organic chem,english (the medicine prereqs and MCAT subject material) is a lot easier than higher level biomedical engineering courses which I took for fun.

    Med school 4 years, 3 years internal med, 2 subspecialty, means I am prob the youngest med onc in Canada at age 31. No masters, no PhD, no post subspecialty fellowship. But I have a 1 year old and another one on the way and there are more important things in life (like spending time with your family) and I chose these over an accademic career. Will I be the the most respected expert in my field – not a chance. Do I have scintillating clinical dilemmas to solve each day in a rewarding field of medicine – absolutely. And tell me what area of medicine is more gratifying than watching cancer shrink away with treatment before your eyes. Balance that with the rapid deterioration seen refractory disease. Does it make you cherish the simple moments shared whith your children? Absolutely. And as much as I went into medicine with all the right reasons and love my job, I live for my wife, son and son/daughter to be.
    Fortunately I have one of the rare positions in medicine where I work 8-5, have weekends free and don’t do call. Oh and I’m an employee, with no major overhead (the usual CMPA/proffesional/association fees but some of that is reimbursed) and yes I do have benefits including a pension.

    So let’s look at the economical perspective. I make ~250k/year which is more than my engineering buddies. For perspective consider this: my brother who is an engineer thinks I make too much money, while my brother-in-law who is also an engineer thinks I’m underpaid. I graduated with ~130k debt which is good considering tuition was ~70k and living in downtown toronto is not cheap, and marrying an Arts student didn’t help from an income perspective. The 40k I started making as a resident (paying my dues ~110h/wk = 120,000km. Have a nice house and will pay it off as well as my other debts over the next 8-10 years. Net worth at age 31 = -140,000 with debts to service. I make a comfortable salary and am happy with this. Remember I didn’t go into medicine for the money.

    Would I have been better off economically to stay in Engineering? Probably. My brother-in-law is two years younger than me, and at age 29 earns ~150k with good job security and benefits including stock options working the same hours. oh and he’s been working since 4 years post grade 12 not 13.5 years later. Net worth: ??? But he’ll definitely have a net worth = 1million long before me.

    Another consideration which nobody seemed to comment on: for every physician making > 1 million / year there is another making < 100,000. I have a tremendous respect for family physicians. They have to deal with people like (see multiple posts above for examples) with vague headaches and tummy complaints all day long and still be alert and prepared for dealing with a Zebra when it walks into the office. Yet we undervalue them as Canadians. Even within my specialty of internal medicine there is a huge discrepency between the renumeration between infectious disease/geriatrics at the low end and nephro/cardio/gi at the other end. The disparity between physicians is much greater than the take home pay of a hard working full time physician in a lower renumerated discipline.

  174. 175. ken

    When you consider what hockey players make per year, physician’s pay seems very reasonable.

    As for foreign doctors, do you really want someone from the third world operating on your eyes without extensive retraining?

    Doctors work hard, and specialist’s Ferraris sit in the garage because they never have time to drive them. Never, ever judge another’s pay unless you walk in their shoes….I would not want to be a physician (or a nurse).

  175. 176. Likes Teeth

    The dollar breakdown is heartbreaking, the personal toll is worse.

    Cost = $88,000 dollars -4 years tuition and living expenses for an Undergraduate degree at a respectable University, achieving marks sufficient for entrance into Medical School : (this could vary greatly depending on circumstance – but let us consider: 6,000 / year tuition, 16,000 / year living expenses)
    Cost = $2,000 – MCAT prep + write, applications, travel, interviews
    Cost = $132,000 – 4 years Medical school tuition, plus living expenses similar to undergrad.
    Cost = $8,000 – Interviews, electives, prep – (ie: travel is pretty expensive) for entrance into residency program.

    This adds to: $250,000, living very modestly during formative training.

    That means, a newly minted resident doctor is $250,000 dollars in debt before they ever start earning – wait for it… a single dollar.

    If the doctor’s brother was a tradesperson, working in a resource rich community (ie: fort mac, or in the gaslands) – it is not unreasonable for him to make – 80,000 dollars a year as an apprentice, and more even with seniority… (300k as an electrician is not unthinkable, albeit – he would be working hours like a busy doc) – then it is feasible that the tradesman could have made 1 million dollars in the time it took his brother to get his MD and go 250,000 dollars into debt.

    Tradesman after 8 years @ 120,000 (this is not an unreasonable mean) = 960,000 dollars
    Doctor in training up to residency after 8 years : (-) 250,000 dollars

    Residency typically pays 50,000 dollars the first year, and increases by 4,000 dollars per year. Therefore in the subsequent 5 years, the doctor will make 310,000 thousand dollars, while his brother will make 600,000.

    After 13 years, it is possible that the resident now turned physician will finally start making some decent money. At this point, assuming he paid no interest on his loans (not likely) – he might have been able to live off of 60,000 dollars over the 5 years (that is to say, 12,000 dollars a year). If he lived poorer than he did during training, then this is a possibility. Assuming he is therefore no longer in debt, compared to his brother:

    :::::::::::::::::::::::13 years worth of effort:::::::::::::::::::::::::::::::
    Tradesman: 1.46 million dollars grossed.
    Physician: 0 dollars grossed.
    ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

    Certainly – these numbers are open to some interpretation, but you can see that for the doctor – the personal sacrifice – 13 years worth of living as a poor student on 16,000 dollars (likely less) annually – is significant. There is virtually no way that he could afford to start a family, buy a house, drive a nice car, or spend extras on holidays, getting married, or helping his loved ones.

    He is not only nearly 1.5 million dollars behind his brother financially, but 13 years behind him regarding those important things that this forum treats as tertiary adjuncts.

    There are a lot of ifs for the doctor on his journey. Good marks, good extra curricular activity, community leadership, advocacy, research. There is only so many hours in a day, and the doctor is expected to sleep for some of them. Getting accepted to the program(s) is a waiting game full of ifs. Sleeping is iffy. Social life is non-existant.

    I personally do not think doctors are remunerated to a degree which reflects the years of personal sacrifice they undertake to be generally mistreated by ill-informed pundits who have a cold and think doctors make too much money. Whatever our doctor ends up earning – it will take at least a while to catch up to his brother, with 4 kids, a house that is almost paid off, a few motorcycles, a nice truck, and yearly vacations that have turned his eyes into wistful gems as he regales you with interesting stories from his travels.

    Do yourself a favour, and learn how to be valuable in a trade.

  176. 177. Chinstrap

    Likes Teeth has made a clear, although biased, case that being in trades is better and more lucrative than being an MD. The cost of being an MD has been exaggerated while minimized for being in the trades. For every trade making a killing in Fort Mac( who wants to live there anyway?), there are also trades who make $30/hr and struggle to get business.

    You have forgotten that trades can take 5 years to qualify for hours. A friend just started his electrician training and has been on the bench waiting for the union to call him up.

    The original point in the article is about MD being underpaid. My spouse is now starting as an ER doc in the GTA so we know what the pay is and it’s more than $250k/year.

  177. 178. PhysicsProf

    Wow. great posts. Bottom line is depends on where you live. Where we are (Canada) my wife pulls in over 800K per year, and that is with time off and nice vacations. Her colleague pulled in over 1million last year. They are both Radiologists. It’s fee for service, and since most drs look at imaging as “the norm”, there is no shortage of business. In Ontario, it is the norm to pull in well over 400K as a radiologist. I know this as a fact since my wife was offered a job in Hamilton, and that is the going average salary there.

  178. 179. PhysicsProf

    I should mention that if you work less, you make less. My numbers above involve 16 hour days, and a lot of clinics. Her attitude is freedom 45. Work hard now, and then retire early. When she finished residency, she was already pulling in over 200K from day one. We are not in Ontario now, and the figures I mentioned are quite specific to our region. BTW, cost of living here is nothing like Alberta or BC – our home cost less than 300K, and it’s a 4000 sq ft home

  179. 180. PhysicsProf

    So……even if a trades person makes 1.46 million over 13 years, my wife has destroyed that figure in under 3 years. Not everyone can be a dr, or a specialist, and yes, some make less than others. However, for us, all of those years in school have paid massive dividends. We paid off our house in cash (no mortgage), have over 2 million in savings, and our kids education is already paid for. To each his/her own, but remember, just as in the trades, not everyone is going to get rich.

    We are very fortunate, and very grateful for what we have. What we should all (as a society) be looking at are athletes that pull in 7 figure salaries, and no one even bats an eye lash.

  180. 181. PhysicsProf

    ….sure, while you are in school, you make less than a person, say in the trades. However, even as a resident, you are making half decent coin (so, ignore that whole $0 over 13 years nonsense). If in less than 3 years you can make what took someone 13 years to earn, who is the better off? It’s not a competition, but if you are going to start quoting figures, then at least be aware of the facts. Fact, out debt was under 40K. Fact, it is possible to make over 1 million per year as a specialist. Fact. Paying your mortgage off in 2 years is totally reasonable (unless you’re an idiot and buy what you can’t afford). Fact. Trades etc are great, but you can easily out-earn these jobs within a few years if you go into the right field. Is money the objective? No. However, don’t be fooled. Drs make a lot of money, and if they don’t, they have very comfortable lifestyles, and dictate their own hours.

  181. 182. PhysicsProf

    Oh, and that whole “incorporation of drs” was spot on. My wife “earns” 120K per year as far as ccra knows. The rest? In her business taxed at 16%. I suspect that a very large portion of the facts/figures don’t take into account that what a dr claims on their T1 is not what they actually bill. In our case, 800K+ per year (excluding my salary), but taxed at 120K per year. We are under 40, have over 2 million in cash in the bank , and don’t regret a thing. Our kids can go to any school they wish, and if it took 13 years to get there, who cares? Not everyone is the same, but to say that drs make little $$ is very misleading. If you work in a rural area, cost of living etc normalises things to a great degree. Also, banks line up to offer us cash. Trades? Lots of forms and justification for your loan. Sorry to rant and sound so bitter, but drs work hard, and deservedly get paid a lot.

  182. 183. Chinstrap

    PhysicsProf
    I think this recent rejig in Ontario with the gov’t adjusting fees has lowered Radiologists billing ability. I haven’t looked into things but I know some specialists were adjusted up and some down.. It seems like you are out of Ontario now so it doesn’t matter.

    Regarding the $800k, wow she must be working her butt off as that’s really high. As my spouse is just starting out in ER and it’s started trickling in now. We’re thinking she could do $350k and still have a nice lifestyle (vs. on call specialists) which is nice after the schooling and her tuition.

  183. 184. Chinstrap

    That’s a great point about incorporating. We need to look into that for next year as that will be my spouse’s first full year as a doc. When we chat with the accountant/lawyer’s about this we will get the full picture. I guess the thing is the money is kept inside the corp? Then you use that money to buy your house, invest in stocks, etc?

  184. 185. SST

    @Prof: “They are both Radiologists. It’s fee for service, and since most drs look at imaging as “the norm”, there is no shortage of business.”

    “As many as 30% of diagnostic imaging procedures are deemed inappropriate or contribute no useful information.”
    http://www.newswire.ca/en/story/658497/as-many-as-30-of-diagnostic-imaging-procedures-deemed-unnecessary

    Self-supporting system, I guess.

    And just imagine if we were all high-paid doctors…
    The one and only plumber/mechanic would make 100 times any of them.

  185. 186. uptoolate

    Figures on doctors’ incomes are from gross billings not their reported income on personal tax returns. The numbers are before overhead, malpractice, professional organization dues or any other costs come off. Most doctors employ at least 2 additional individuals. Incorporation does work for those doctors who have excess income after expenses as a way of deferring taxes but eventually taxes have to be paid. There is no free lunch. Do people really think that the government would let someone pay the small business corporate tax rate and then let them take the money out later with no additional tax owing? Incorporation is a tax deferral tool that itself costs several thousand dollars a year to set up and according to the OMA is only useful to doctors with 70k+ in excess earnings over what it costs them to live. Many doctors aren’t able to take advantage of incorporation because they either don’t have a high enough net income or do but get caught up in a lifestyle that forces them to spend too much money on the personal side.

    Also, I don’t think the income of radiologists represents the reality for almost all other doctors. They work in an environment where they often have many people doing work for them but to whom they don’t have to pay salaries. Overheads are very low or zero and patient volumes are very, very high.

    Many current medical students are running up debts for school in the 200k range after undergrad and medical school. Residents are not paid enough to get out from under this debt before finishing their 3-8 year postgraduate training. I would say that the estimate made above about $0 net income for 13 years is the reality for many if not most medical trainees these days.

  186. 187. UndergradMedHopeful

    Very interesting article. I’ve been spending about 3 hours reading through it and I found a lot of useful information (the arguments between engineers and doctors were irrelevant in my opinion). I’m an undergraduate student approaching the end of my first year, about to decide what to specialize/major/minor in. This article could really help an undergraduate student, or any student wishing to pursue a career in medicine, since it offers information regarding the type of lifestyle and path to a medical career through the viewpoints of many different knowledgeable people. After reading this article I know that I still want to become a Medical Doctor and have reinforced my confidence in knowing I am following in the right path. However unfortunately my marks have not been stellar first year, so I’m concerned about my chances of getting into a Canadian medical school and have begun considering international medical schools (i.e. in the U.S. or Caribbean). Can anyone shed some light on one’s actual contingency of practicing as a physician in Canada if a degree is earned internationally? Any help would be appreciated. Thank you.

  187. 188. SST

    I know of a person who is going to med school somewhere in the Caribbean. Same level/quality of education, but I believe it is one year less of schooling than US/Canadian unis.

    A recent development from the government of British Columbia which offers a $100,000 signing bonus for a 3-year contract to practice in a rural setting.

    Something to think about.

  188. 189. Danielle

    SST: while a $100k bonus is great many people forget about the taxes associated with it. I have a friend (not a doctor) who got a $100k bonus as part of his companies annual bonus program. This equalled his salary per year. He was ecstatic at first but then got the actual payment and was disappointed to see it was about half that amount. I didn’t ask the exact number but he was disappointed.

    Don’t get me wrong, a $100k bonus is awesome, but anyone who gets that definitely won’t take home anywhere near that original amount.

  189. 190. SST

    As far as I understand, it’s $100k paid in two parts, book-ending the 3-year contract.

    I’m sure there are a few creative ways to drastically reduce taxes on that sum.

    Perhaps a mental shift is in order for people who are “disappointed” at receiving tens of thousands of dollars in ‘bonus’ money instead of a hundred thousand. :)

  190. 191. Chinstrap

    Undergradmedhopeful

    Marks are important but you should check very carefully what each Cdn med school allows, etc. For example, some may only look at your top 3 years, allow you to throw away a year and some may allow you to retake some courses (take bird courses) to bump up your grades. For example when my wife was applying UWO allowed you to have some retakes, etc.

    So all is not lost but basically you do need to have very good marks and if you get to an interview and you have a few bad marks you have to maturely explain. If you just finished your first year, maybe consider taking a summer course that you can ACE!

    Getting into Cdn med school take 3 things: Marks, MCAT, Story
    if you have good references/connections that also helps
    What I mean by story is are you well balanced, leadership skills, travel abroad, volunteer work, languages, sports achievements, music ,etc. In my wife’s class there were some seriously talented people.

    Regarding int’l schools, Canada residency programs to take a few residents from int’l programs. However, there are very few spots but if during med school in say Grenada or Ireland you come over and do some rotations in some specialites and make connections with staff it can be done. We know a guy who was Cdn, med school in UK and got the one ENT spot for an int’l student at UOttawa.

    My thoughts are that the UK route is not good because it’s too long. Their residency/program takes many years and then you would come back to Canada and do another residency. best bets are Ireland, Caribbean or the USA. CAribbean schools aren’t looked up in great light but if you go and then start clerkship in the US (as they do) and then get a few interships, shadows back in Canada at a couple of different University than you have a chance. First though, I would keep tring for Canada.

  191. 192. Chinstrap

    Regarding bonuses, a northern Ontario town (Rainy River) had posted last year for a family med Doc and the total compensation was like $550k or something if the doc signed on for two years.

    HealthForceOntario has a program that pays ER docs to go to small towns in need and pays them an extra $150/hr ( on top of the base of $180 approx) plus $600 driving there and $600 driving back (over 4 hours). Thus a 12 hour shift in North Bay, one could $5000 for one day. They will also put you up in the hotel for free.

    Pretty good work if you can get it..

  192. 193. Chinstrap

    Doctors can reduce taxes by incorporating. Well, it is actually sheltered within the corp. where one can invest in stocks (sometimes real estate…), etc. and let it grow compound free like a giant RRSP. They can also deduct expenses, cars, fees, etc. to write it off against taxes.

  193. 194. Jason

    I know these numbers are old but they are flawed. I know first hand a busy oncologist in Toronto will take home close to 1 million with no overhead (i.e. they work out of a cancer centre). Lots of money but well deserved.

    It pays to go to school folks.

  194. 195. JSR

    If it was an easy job everyone would be a doctor. Truth is, it is very difficult getting accepted to medical school, getting through medical school and practicing medicine. Most people have no idea how complicated the practice of medicine really is. Doctor’s deserve every cent they make!

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