Yep there is a tonne of variety.

I generally consider in medicine that if you can make about 100k per day worked then you are doing well (eg 3 days a week = 300k per year, assuming 6 weeks vacation per year) considering the flexibility, autonomy and general satisfaction in many niches of medicine. Nice middle ground especially with young kids.

Different story if you are first 5 years of practice and want to build up to that 1mil buffer – by all means grind it out.

Ah, gotcha. Thanks for the clarification. I guess I realized, but I forgot that some doctors make $200K. $1.6M is totally believable.

“Many work to 65+ just because they love it. So no need to grind.” Got to love that!

I’m talking 200k vs 1.6M+. Some subspecialty surgeons can earn over 2M (these are extreme outliers), and that is only the public billings for insured services (I am in Canada) – any private fees are opaque and not disclosed, but you could comfortably add another couple hundred K at least to that number.

And to clarify both the primary care MD and the surgeon are sole proprietor with board owning their office and paying all overhead expenses.

Again, this is extreme and true for only the highest billing specialty surgeons. For the bulk of MDs, the variance would still be significant, at least 4X between primary care office and, say, staff radiologist with the latter having all expenses paid for in public system.

The funny thing is that for the specialty surgeons, some of these are actually a great lifestyle – start at 8:30, home by 4:30 kind of vibe, billing 4-6K per day with near 100% autonomy. Many work to 65+ just because they love it. So no need to grind.

The grind is the brutal hazing/borderline abuse that surgical residents endure in their 5-7 years of post med school training, as well as the absolutely vicious competition to get one of those residency spots.

Thanks for reading and sharing your thoughts doc. An 8X salary difference is huge! Are we talking like $300,000 vs $2.4 million or something? I can see how sole proprietors owning their own practice could make that level.

Seems like it may be worth it to grind for 10 years at that high level and then reconsider. Should be set for life after that, if expenses are managed properly.

Would be interesting to see which careers have the widest standard deviations in salary range – don’t know where this data would be found but would make a great analysis. I’m in medicine, and the difference in salary between full time working MDs is immense, easily an 8X spread between an overworked primary care MD with an inefficient office, and a subspecialty surgeon sole proprietor, each owning their practice. I’ve seen the books for both and it really is that stark.

Cant tell you how many med students I’ve met that wouldn’t consider my “low pay” specialty. I like it like that – less competition :). Sometimes it pays to go where the competition isn’t.

Keep up the great work.

Thanks Matthew! I’m doing my best to put that perspective into practice, but it’s a process and I still have much to learn. I wish you the best in your journey.

Thanks Sam, and agreed re: the value of options! And yes, the kids are always full of surprises. :-) I tease my son-in-law about getting a “real” job, but he built an amazing business that is fun for him and helps balance the lifestyle he and my daughter want, so he’s an inspiration to me.