Unhappy with job (MD) - need perspective

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TheoLeo
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Unhappy with job (MD) - need perspective

Post by TheoLeo »

I am a young MD during specialty training living in Europe (referred to in the US as residency). The field is internal medicine. They pay is decent, but not great. For comparison, I make a little more than what a teacher at my career stage earns here. Salary will increase steadily over the next years but will likely reach a ceiling of around 100 k or so after residency. My working hours on the other hand are bad. After years of grinding through med school, I now work 70-80 hours a week. In my spare time I should continue to study and stay current, so work basically continues after work. On top of that, work obviously comes with a high degree of stress and responsibility.

All this makes my passion and interest for medicine wane, as I feel like I am not adequately compensated for the work I do. However, I realize that most people feel like they should be paid more for the work they do. So I guess I need some perspective. Am I being ungratefull?
jaqueisse
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Re: Unhappy with job (MD) - need perspective

Post by jaqueisse »

Don't link your income with your happiness. You may discover with time they do not necessary correlate. Some people do volunteer work and feel great happiness, some people are paid very high amounts but hate their job.

You are working too much. When you are able to work less, you will enjoy your job more. You may even realize it is worth giving up pay to do so. Find balance in your life and you will find that you still have a job that can have great meaning and purpose, even if you earn less than others.
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goodenyou
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Re: Unhappy with job (MD) - need perspective

Post by goodenyou »

Ungrateful to whom and for what? That you have a job? Europe has a different perspective on medical education and healthcare than the US. Residency training in the US is marked by long hours and meager compensation as well. For now, physicians' salaries in the US rise dramatically after the 8 years of education after high school and minimum 3 years of training (usually 5-6) after medical school. The average debt of a US medical student is $230,000.

I would encourage you to work hard in residency, receive great recommendations and come to the US for a specialty fellowship (if possible) if you want to be better compensated. Your earning potential for your hard work (and now life-threatening exposure) will be much better compensated.
"Ignorance more frequently begets confidence than does knowledge" | Do you know how to make a rain dance work? Dance until it rains.
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Watty
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Re: Unhappy with job (MD) - need perspective

Post by Watty »

The white coat investor web site is run by a doctor who is regular poster here. You might check that out including the forums there to see what input other doctors can give.

https://www.whitecoatinvestor.com/
Doctor Rhythm
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Re: Unhappy with job (MD) - need perspecitve

Post by Doctor Rhythm »

I'm well out of training and work in the US, so my perspective may not be relevant to you - especially if you're from France (https://www.medscape.com/slideshow/2019 ... rt-6011814). It sounds like you're looking for either a pep talk or someone to commiserate with, rather than career / financial advice, so I'll provide the former. Things get better - hours become more flexible, salary increases, and hopefully, your self-esteem improves and sustains you when the extrinsic rewards (money, recognition, power) of your career feel inadequate. If you're not feeling this internal satisfaction, then maybe you are in the wrong career, because I'm sure there are easier ways to earn 100,000 euros.

To keep this at least somewhat on-topic, I'll add that comparing compensation between Europe and the US is tricky. 100K would be a low salary for a US physician, but our social welfare benefits are also lower.
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NerveDoc
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Re: Unhappy with job (MD) - need perspective

Post by NerveDoc »

Doctor Rhythm wrote: Sun May 10, 2020 6:41 pm I'm well out of training and work in the US, so my perspective may not be relevant to you - especially if you're from France (https://www.medscape.com/slideshow/2019 ... rt-6011814). It sounds like you're looking for either a pep talk or someone to commiserate with, rather than career / financial advice, so I'll provide the former. Things get better - hours become more flexible, salary increases, and hopefully, your self-esteem improves and sustains you when the extrinsic rewards (money, recognition, power) of your career feel inadequate. If you're not feeling this internal satisfaction, then maybe you are in the wrong career, because I'm sure there are easier ways to earn 100,000 euros.
+1. I cannot speak about compensation, since I live in the US. However, I would not base expected future job satisfaction on how you're feeling during training. I went through residency just as they were implementing the maximum 80 hour work week, and they were not implementing it very consistently in my program yet. It was not uncommon for me to work 100 to 120 hours a week, and it was sometimes hard to keep a positive attitude in that setting. I agree that things get better. However, if you feel like it's a completely wrong fit, better to realize that now.
Last edited by NerveDoc on Sun May 10, 2020 7:04 pm, edited 1 time in total.
stoptothink
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Re: Unhappy with job (MD) - need perspective

Post by stoptothink »

goodenyou wrote: Sun May 10, 2020 6:32 pm Ungrateful to whom and for what? That you have a job? Europe has a different perspective on medical education and healthcare than the US. Residency training in the US is marked by long hours and meager compensation as well. For now, physicians' salaries in the US rise dramatically after the 8 years of education after high school and minimum 3 years of training (usually 5-6) after medical school. The average debt of a US medical student is $230,000.

I would encourage you to work hard in residency, receive great recommendations and come to the US for a specialty fellowship (if possible) if you want to be better compensated. Your earning potential for your hard work (and now life-threatening exposure) will be much better compensated.
I 10000000000% agree with you, but this could very easily turn into a political discussion.
afan
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Re: Unhappy with job (MD) - need perspective

Post by afan »

From an income perspective, depending on where you are training, you may be able to earn more money in another country.
Internists in the US are relatively low on the pay scale as American doctors go, but they make more than you are indicating.
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climber2020
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Re: Unhappy with job (MD) - need perspective

Post by climber2020 »

TheoLeo wrote: Sun May 10, 2020 5:58 pm All this makes my passion and interest for medicine wane, as I feel like I am not adequately compensated for the work I do. However, I realize that most people feel like they should be paid more for the work they do. So I guess I need some perspective. Am I being ungratefull?
Hell no. If my income as a doctor was capped at 100k, I would quit in the middle of typing this sentence.

Is it possible to change your specialty? I know a few people who jumped ship from internal medicine to anesthesiology for example, and they seem much happier. If this is a possibility, now would be the time to do it.
Spring garden
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Re: Unhappy with job (MD) - need perspective

Post by Spring garden »

Those are long hours, and even though many physicians in training do them it doesn't make them easy. It's TRUE, what you do is more valuable than your current compensation, but don't make the mistake of equating your happiness with your salary. Take a step back and think about how far you have come (and pat yourself on the back), and that it won't be long before your time at work gets better.

Not to say you aren't already, but you will become even more efficient as you gain more experience and that will reduce the time you need to put in outside of work hours. This too shall pass.

Spend a little extra time with a few patients this week and learn more in depth about how their illness impacts them and their families. You will feel better and be able to take even better care of your patients.
mhalley
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Re: Unhappy with job (MD) - need perspective

Post by mhalley »

Not sure about the jobs overseas, but in the US Internal med can have many types of jobs, ranging from hospitalist to urgent care to private practice, not to mention the numerous sub specialties. Training is definitely a tough few years, but being an attending will offer numerous types of practice.
TheNightsToCome
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Re: Unhappy with job (MD) - need perspective

Post by TheNightsToCome »

TheoLeo wrote: Sun May 10, 2020 5:58 pm I am a young MD during specialty training living in Europe (referred to in the US as residency). The field is internal medicine. They pay is decent, but not great. For comparison, I make a little more than what a teacher at my career stage earns here. Salary will increase steadily over the next years but will likely reach a ceiling of around 100 k or so after residency. My working hours on the other hand are bad. After years of grinding through med school, I now work 70-80 hours a week. In my spare time I should continue to study and stay current, so work basically continues after work. On top of that, work obviously comes with a high degree of stress and responsibility.

All this makes my passion and interest for medicine wane, as I feel like I am not adequately compensated for the work I do. However, I realize that most people feel like they should be paid more for the work they do. So I guess I need some perspective. Am I being ungratefull?
Very few people can be happy working 70-80 hours per week. There may be no way around this while in training, but you should be able to find a better practice setting when your training is complete.

However, 100K is inadequate compensation for a full-time physician.

"In my spare time I should continue to study and stay current, so work basically continues after work."

This never ends, so you're in the wrong field if it isn't acceptable.
MedSaver
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Re: Unhappy with job (MD) - need perspective

Post by MedSaver »

No MD here in the states would work for $100k, even the worst paid specialties like pediatrics make more like $180k. I’m sure there are non-monetary things like good insurance, less/no medmal, free education that can make up for some part of the difference but to me your salary still seems low. You could try to come here, but even skilled workers are having difficulties getting visas because of politics and you’d need sponsorship for several years while earning what residents make. You’d have to take the boards here too.
kidshrink
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Re: Unhappy with job (MD) - need perspective

Post by kidshrink »

Please give psychotherapy a trial. With the help of a good therapist, I think you will gain some perspective on your next steps.

I am shocked at the number of psychiatrists in my field who do not seek their own therapy. You can only purchase so many pairs of shoes or devices or boats to numb the emotional pain. One friend texts me weekly about how unhappy she is with clinical psychiatry and now administrative work for insurance companies. She rationalizes against my suggestions for her to seek therapy. Cannot help those who don’t want to help themselves.

After training, you could reduce your hours (I work 32-36) or do something non clinical. Increase insight into yourself will guide the process.

Good luck
Cipro
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Re: Unhappy with job (MD) - need perspective

Post by Cipro »

Would suggest looking into working for pharma/biotech. Physicians are in demand. Better hours/better pay. Interesting work.
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oldfort
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Re: Unhappy with job (MD) - need perspective

Post by oldfort »

On another thread, you posted you had all these benefits not available in the US

- universal healthcare
- unemployment insurance which pays 60 % of income for 12 months and then social security
- a pension that will cover about 70 % of my averaged salary
- zero or very low student debt for me and future children, good public education
kidshrink
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Re: Unhappy with job (MD) - need perspective

Post by kidshrink »

oldfort wrote: Sun May 10, 2020 10:40 pm On another thread, you posted you had all these benefits not available in the US

- universal healthcare
- unemployment insurance which pays 60 % of income for 12 months and then social security
- a pension that will cover about 70 % of my averaged salary
- zero or very low student debt for me and future children, good public education
Clearly they are not a substitute for having time off and control over ones schedule.

Alternatively, at least he doesn’t have to worry about healthcare costs, unpaid unemployment, retirement income or student debt, which is a lot more than US medical doctors can say.
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goodenyou
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Re: Unhappy with job (MD) - need perspective

Post by goodenyou »

kidshrink wrote: Sun May 10, 2020 11:13 pm
oldfort wrote: Sun May 10, 2020 10:40 pm On another thread, you posted you had all these benefits not available in the US

- universal healthcare
- unemployment insurance which pays 60 % of income for 12 months and then social security
- a pension that will cover about 70 % of my averaged salary
- zero or very low student debt for me and future children, good public education
Clearly they are not a substitute for having time off and control over ones schedule.

Alternatively, at least he doesn’t have to worry about healthcare costs, unpaid unemployment, retirement income or student debt, which is a lot more than US medical doctors can say.
So do other citizens in his country that do less demanding and stressful work. It sounds like he would rather be compensated more than a school teacher now and more than others in a few years who make $100k/year doing much less important and demanding jobs.
"Ignorance more frequently begets confidence than does knowledge" | Do you know how to make a rain dance work? Dance until it rains.
petrisunset
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Re: Unhappy with job (MD) - need perspective

Post by petrisunset »

Residency years = dog years = very long hours + relatively meager compensation. That’s true in US and EU (I’ve done both)
Once you have a board certification things are getting better. This true for USA and EU. Also for clinic and private practice. If you want to make an academic career the very long hours continue, but compensation grows - this is conceptually also similar in USA and EU.
The key difference between USA and EU, as others already eluded to, are: Compensation gets much, much higher in the USA, whereas social welfare benefits are much better in EU - in particular health care (you never go bankrupt in case of deteriorating health) and costs for (higher) education of children.
Important for you to know is where your passion lies. Do something you truly love and get excited about every day. In this case the long hours don’t matter (so much).
If direct patient care is not so close to your heart, check out career opportunities in the industry (e.g. biotech, pharmaceuticals, medical devices). A fair number of accomplished MDs go there mid-career. Strong purpose, less bureaucracy, less institutional rigidness, usually better work/life balance (though not a walk in the park either), fairly good compensation and often global exposure to the work. If you get your board certification and license in the clinic first, then the industry provides great opportunities and you always have the safety net of going back to direct patient care in case industry is not for you.
Good luck and all the best for your career.
BH+
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Re: Unhappy with job (MD) - need perspective

Post by BH+ »

If you are looking for a better standard of living post-residency, you could consider immigration to the US, Canada, or Australia. Pays are better and taxes are lower in these countries, but it is likely that you would have to go through another few years of training. You could also consider temporary short term (or permanent) work in other jurisdictions such as Dubai or Singapore to supplement your income and potentially give you a tax advantage.

Things could get much better for you. You could work 6 months of the year outside of Europe and spend the other 6 months travelling or on other hobbies. There are a lot of options out there.
Katietsu
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Re: Unhappy with job (MD) - need perspective

Post by Katietsu »

Do you feel your compensation is just not fair now or is it that you feel you will never be fairly compensated? Are you just unhappy with your current job duties and hours or do you feel you will always be unhappy? These are very different. Medical residents, tenure track professors, big law junior associates are all paid very little per hour relative to their level of education, at least in the US. No rational person would disagree with that.

On the other hand, if you do not want to be in medicine, better to realize it sooner rather than later. Is there something you want to move towards? It is much easier and smarter to make a change if you know what you would rather do.
minimalistmarc
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Re: Unhappy with job (MD) - need perspective

Post by minimalistmarc »

I’m a full time physician in the U.K. internal medicine.

Gross income is around 110k but then you get 6 weeks annual leave, 1 week parental leave, 10 days study leave, 10 public holidays, good sick leave, defined benefit pension so you need to factor these things in. Also, before I had 2 kids I had the energy to do a lot of extra work and you can easily earn 150 - 200k, although you need to keep an eye on the insane tax traps in the U.K. that affect most doctors.

Work life balance gets better once you finish your training.
nydoc
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Re: Unhappy with job (MD) - need perspective

Post by nydoc »

Don’t get fooled by benefits. I am a full time employed physician in US. I get 5 weeks vacation, 10 days CME, 2 weeks sick leave, 8 public holidays, 401K match, 1 week parental leave too. Fact is salary in Europe is too low for a physician and if you really want to be paid for your efforts you should move to US.
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TheoLeo
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Re: Unhappy with job (MD) - need perspective

Post by TheoLeo »

Thank you all for the input. Really appreciate it. I would love to work in the US, but I don´t think I have it in me to repeat all the big exams of med school and then go through residency a second time. So this is not an option for me. But it gives me hope that some MDs here seem happy with their careers later on. Most of the attendings at my clinic are miserable (academic center).
bayview
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Re: Unhappy with job (MD) - need perspective

Post by bayview »

TheoLeo wrote: Mon May 11, 2020 10:38 am Thank you all for the input. Really appreciate it. I would love to work in the US, but I don´t think I have it in me to repeat all the big exams of med school and then go through residency a second time. So this is not an option for me. But it gives me hope that some MDs here seem happy with their careers later on. Most of the attendings at my clinic are miserable (academic center).
Is your clinic and academic center hard-hit by COVID-19?

Perspective changes when you’re in the equivalent of WWI trench warfare with shells flying and mustard gas creeping over the ground.
The continuous execution of a sound strategy gives you the benefit of the strategy. That's what it's all about. --Rick Ferri
IMO
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Re: Unhappy with job (MD) - need perspective

Post by IMO »

kidshrink wrote: Sun May 10, 2020 11:13 pm
oldfort wrote: Sun May 10, 2020 10:40 pm On another thread, you posted you had all these benefits not available in the US

- universal healthcare
- unemployment insurance which pays 60 % of income for 12 months and then social security
- a pension that will cover about 70 % of my averaged salary
- zero or very low student debt for me and future children, good public education
Clearly they are not a substitute for having time off and control over ones schedule.

Alternatively, at least he doesn’t have to worry about healthcare costs, unpaid unemployment, retirement income or student debt, which is a lot more than US medical doctors can say.
OP, seems non-productive to compare your salary to the salary of a US physician. Your probably also doing vastly better than some physician working in a 3rd world country.

Bigger question is in regards to your long hours, is that something that with some time is going to come down significantly? Also as one gets more and more experienced, I suspect you'll have less stress from managing some complex situations than you do currently. Financially you say things do rise in the future and in the future you will make more than a teacher, correct?

I would suspect that it is not unreasonable to have a relative decent quality of life with a physician salary in Europe. I couldn't imagine someone not doing research into medicine from both the work and financial aspects before committing to training? In the US, there are many professionals that put in 2 to 4 years+ education after college (with the added costs/deferred incomes) and have no where near the higher salaries of US physicians and seem to also have a decent quality of life in the US.

I'd be more worried about clinical burnout if the hours didn't improve in the future. I think it's potential burnout rather than your salary that is of most concern. Try to find positions that allow the best work/life balance. If your really burnt out, throwing money on it can help, but only to a certain extent.
JPM
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Re: Unhappy with job (MD) - need perspective

Post by JPM »

Agree with the above post suggesting your getting some psychotherapy. The psychological stress of medical training is not always anticipated. You are naturally in over your head during those years, frequently with responsibility beyond your level of knowledge and experience . I trained in the seventies and back then a survey of house officers in the US found that 1/3 were in therapy at some time during residency. That matches well with what I could gather from conversations with friends. In my training years a mutually supportive group of residents was an important key to everyone maintaining adequate equanimity thru training.
kidshrink
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Re: Unhappy with job (MD) - need perspective

Post by kidshrink »

JPM wrote: Mon May 11, 2020 6:04 pm Agree with the above post suggesting your getting some psychotherapy. The psychological stress of medical training is not always anticipated. You are naturally in over your head during those years, frequently with responsibility beyond your level of knowledge and experience . I trained in the seventies and back then a survey of house officers in the US found that 1/3 were in therapy at some time during residency. That matches well with what I could gather from conversations with friends. In my training years a mutually supportive group of residents was an important key to everyone maintaining adequate equanimity thru training.
That’s an interesting statistic that 1/3 were in therapy at some point. Yet the rate of suicide in physician is still above average. It speaks to the high level of stress within the medical profession
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