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Discussion Starter #1 (Edited)
Good day to everyone.
I'm posting to you to consult you on what my next step in life should be. I was the owner of a 2014 MP4-12C Spider that I crashed in January 2017 back then when I was a medical student.
Since then, I was not able to be active online because I have joined Neurosurgery Residency Training Program. Since the Corona pandemic, I finally have the time to do things like post on this forum.
I was interested in Neurosurgery since before Medical School due to 1) prestige and childlike thinking, and 2) During Medical School, I found Neurosurgery to be the highest paid Medical Speciality:

"The median income is $704,170. The lowest paid neurosurgeon earns at least $350,000 while the top 10 percent make up to $1,229,881 a year"

During my final medical school year, I made a final decision to join dermatology. However, because my whole CV was Neurosurgery and I spent all my medical school years focusing on knowledge rather than marks (GPA is high 4.76/ 5) but I never took the effort to work on my Medical Licensing Exam so I got 76/100 which is a bad mark. Since my GPA was high, I would still score on the edge of competitive programs like Neurosurgery and Plastic Surgery but just a tip away from Dermatology. Had I staged Dermatology from early Medical School, I would not have focused on sci-fci knowledge learning and would have simply focused on the boards and would have easily gotten into dermatology and would have done electives to get the attendings attention in Dermatology. I, thus, made the bold decision to continue in Neurosurgery and got accepted because my CV was full of interest in Neurosurgery and they would never suspect I had changed my mind.

Fast forward from October 2018 until now, I'm already 18 months into the program.
I was punished with more Neurosurgery Rotations as I was a bookworm rather than clinically oriented so my experience is rather more than the average 18 month old Resident as my "outside rotations" were delayed till next year so by the end of my second year 6 months from now, I will have 6 months more neurosurgery experience than my colleagues who spent 6 months on outside rotations.

Thus my question is as follows:

Impression:
  • Some of the attending physicians are assholes.
  • No post call so 36 hour shifts 5-7 days a month.
  • All the attendings don't teach and they range from: "don't teach as well as I think they should" all the way to "zero teaching egomaniacs" so: I end up wasting my valuable time observing so many ORs to just receive a few hands on. This is completely different from reading based specialties, like Dermatology, where you are not at the mercy of anyone and you can learn by yourself rather than depend on a piece of shet attending to teach you.
  • Life sucks and they'll likely fail me a year or 2 (6 months of more rotations isn't a free gift, it means fail 1 year eventually). Very low chance I won't fail at all and finish in 6 years total.
Plan:
1- Quit Neurosurgery, I know I'm smart so I know I can get whatever mark Dermatology needs and get into derma by October 2021 - October 2022 Maximum
2- Continue Neuroshitigy rather than switch because starting over is R1 Dermatology out of 4 years program vs R3/ R4 Neurosurgery Resident out of 6-8 years program ( 1-2 years of failure expected because of the attendings superegos)


When I had my McLaren among many other things of my achievements, people always try to belittle and undermine the prices and values of my achievements. Thus, I feel perhaps Neurosurgery would give me the money needed to buy a Hypercar and prevent the enemy from belitteling me as soon as 10 years from today.

Note: Hypercars don't have used values less than 7 digits or high 6 digits:

Example 1 Supercar:
Underminer: Your McLaren 12C is only worth 70K which is the value of a Corvette the local school teacher just bought.
[Worth at least 160K-185K in the US market back in January 2017 but he saw a 2012 with no specs and totalled 2 times for 70K]
Me: My 2014 Spider is $374,000!!
Underminer: 70K. Aventador is the best. Wow, Aventadors are the dream. 70K. Aventador wow. 70K. Aventador is faster.
[Note: These statements by the stupid chicken are spaced over 1 week and always brought up in between discussions by him]
Winner: Underminer. [Remember how confident stupid people are. I will post a picture of a pigeon playing chess with you to illustrate shortly]

Example 2 Hypercar:
Underminer: Your P1 is only worth 700K.
[worth at least 1.5 million but that's as low as his ass can go because he found one with a failed engine and gearbox for 700K and he didn't bother to ask the salesman of the condition. This or don't underestimate the capabilities of a stupid person to fabricate numbers and then believe them]
Me: It's because I'm a piece of shit that's worth nothing. I have failed this life and if I were to amount to anything your chickeness can respect, my car would be north of 1 million dollars.
Winner: Me


I don't need a billion dollars. I only want 100 million dollars. I would not be happy until I have a hypercar and thus I will be infuriated by "losers and haters" until I hit the $10,000,000 mark. If I had a billion dollars, I wouldn't but I know it's the right decision to give away 900 million because 100 million dollars is just enough money to put haters and losers in their place in a comical fun way but not too much money where you win by nuking them like North of 100 million dollars. Sorry for having a short fuse for idiots and being hypercompetitive.

You see if I enter Dermatology (it's not guaranteed that I will be able to enter), the average annual salary is $345,300 so I lose a lot of money every year compared to Neuroshitity's median income of $704,170 with the top 10% making $1,229,881 per year.
I, however, am showing excellent potential in the stock market (the only thing I have time to do during Neurosurgery) so would Neurosurgery waste my time to develop my business skills and I would, thus, lose more money in the long run by not having the free time of Dermatology to hone my business skills. OR is $1,229,881 per year a better more stable investment.
Plus, for family life, I would choose dermatology 100% over Neuroshit but again I'm stuck with up to 4 years wasted if I switch to Dermatology.

In summary:
I want your opinions and impressions on whether (lower income Dermatology + 4 wasted years + time for business skills) is better to get to $100,000,000 or (higher income Neurosurgery + no time for family + no time to hone business skills) is better considering the number of years I could potentially waste by switching careers and my happiness is Dermatology because I love family.
 

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Life is far to short to be miserable.

Cut your losses, drop Neurosurgery and finish out your time in Dermatology, then get an MBA in Finance or related field to pursue your Wall street/business ambitions. Either way, you need a base to launch from and Dermatology offers you a consistent and reliable "fail safe". In turn, this approach will allow to pursue more volatile and risky business aspirations that are separate from your Dermatology practice.
 

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As a doctor looking hindsight your post gives me a chuckle. Are you in the US? As I am and my thoughts are only valid here.
 

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those salary estimates are only valid if you want to live where they make that salary. It also doesn’t account for how many hours they work to get that money.
Just do what you like and find interesting as you will be doing it for a long time. Worry about business outside of medicine as big bucks won’t be made by just doing medicine.
 

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Discussion Starter #5 (Edited)
As a doctor looking hindsight your post gives me a chuckle. Are you in the US? As I am and my thoughts are only valid here.
No not in the US but for all practical purposes, consider the US averages are what will apply to me. I will learn procedures based on market supply and demand so I doubt that I wouldn’t easily be able to outearn or be at least like the average US Practitioner who denies/ isn’t aware that he works for money. Self awareness is very powerful.
Nonetheless, if I find that my services are underpaid for and unappreciated, I will practice 6 months a year in a foreign country and spend the other 6 months in business with minimal work in my country.
 

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That's my point, it wont apply as the US has a very unique type of payment system and a large country with rich and poor areas. So im guessing your area does not have socialized medicine?

There is only 24 hours a day, so you can only operate "THAT" much and see only "THAT" many patients. The high earners from "practicing" are essentially famous in their field (the ones that rich people/celebrities/cash paying people see). If you don't learn from them, you will be in competition from them. Either way a city can only support so many before everyone takes a pay cut.

If you want to look at it from a money type view only, you should check how much a doctor gets paid to do X procedure (not the cost of procedure because that usually includes anesthesia and hospital/facility fees).

so the factors will be pay, in terms of hours/$. A lot of neurosurgeons are on call a lot, get very little money from it unless there is a case. But it essentially ties you down as you are not totally free. Hard to watch a movie/go out of town etc. Location where you want to live and how much competition is there..... and you actually got to tolerate what your doing...…….big plans you have to figure out what business related entities you can enter seamlessly.

My orthopedics neighbors makes more off his surgery center/physical therapy/rehabilitation center than he does operating, but obviously his surgeries feed the other 2.... Things like that are extra income earners..... I don't consider stocks, or franchising a mcdonalds part of this as that's not related to your degree.....

In my opinion cosmetic derm is a great bang for the buck, great lifestyle and there is rarely an dermatology emergency (I mean real emergencies where you have to get up at 3am to figure out)
Radiology is also a good pay/work ratio and a lot of work can be do remotely.
 

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Dude, lots to take in here. I am a cardiac surgeon and by nature we tend to be pretty blunt. You asked for opinions, so here goes.

You started out by saying that you had a MP4-12C spyder in medical school and wrecked it. That tells me a lot. Not saying good, bad or otherwise, but says a lot about you.

Making a decision as to a medical specialty based on income is not a very smart move. Those that do we tend to term "lifestyle docs". I have seen some folks in relatively low income specialties do very well (especially outpatient derm). I have seen some folks in high earning specialties do not so well (poor attitude, poor knowledge base, poor skills, poor work ethic). As you seem to be learning, one will rarely excel in a specialty that one does not like. I have seen a lot of folks go into medicine and particular specialties based on decisions like the ones your are making and all are miserable. I know it is a bit cliche, but those who do the best in medicine and are the happiest are doing what they truly enjoy.

As far as residency training goes, the life of a resident sucks. Long hours, little pay, etc, etc. You will find some attendings who are great teachers and some who are terrible. Stick with the ones who you can learn from as much as possible. If you have a poor attitude, it will shine through so forget about anyone going out of their way for you. The dirty little secret is that the attendings are not there for you and your education!!! Teaching residents comes a distant fourth after patient care, research, getting grants, and publishing. I had some great attendings and some very bad ones. However, I made it a point to learn something from all of them. Even if I were in a case, no one noting my existence, attending is being a jerk, etc., I still would study the way they did things and learned. Sometimes it was learning what not to do. So, residency sucks. Put on your big boy panties and deal with it.

I the end, doesn't matter what you do if you do it well. If you do it well, the money will come. Quite honestly, I think you really need to go back a step and decide if medicine is what you really WANT to do.
 

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Discussion Starter #10 (Edited)
Dude, lots to take in here. I am a cardiac surgeon and by nature we tend to be pretty blunt. You asked for opinions, so here goes.

You started out by saying that you had a MP4-12C spyder in medical school and wrecked it. That tells me a lot. Not saying good, bad or otherwise, but says a lot about you.

Making a decision as to a medical specialty based on income is not a very smart move. Those that do we tend to term "lifestyle docs". I have seen some folks in relatively low income specialties do very well (especially outpatient derm).
Why isn't "Making a decision as to a medical specialty based on income" a smart move?! If you look at the financial status of most, you'd notice that most people have incomes very close to the google median incomes of their respective specializations despite some of them "working hard"/ aspiring to be rich. In other words, most people are not doing well financially. I think you are affording your McLaren because of this statement:
"annual average salary of $567,171 for cardiac surgeons and $681,408 for pediatric cardiac surgeons"
I'm not implying that you don't have business ventures elsewhere or that you are above or below that median. I'm simply stating that whether you have a business or not, you would not have probably been able to finance it with a degree in Family Medicine / ER / Pediatrics.

I have seen some folks in high earning specialties do not so well (poor attitude, poor knowledge base, poor skills, poor work ethic). As you seem to be learning, one will rarely excel in a specialty that one does not like. I have seen a lot of folks go into medicine and particular specialties based on decisions like the ones your are making and all are miserable. I know it is a bit cliche, but those who do the best in medicine and are the happiest are doing what they truly enjoy.

As far as residency training goes, the life of a resident sucks. Long hours, little pay, etc, etc. You will find some attendings who are great teachers and some who are terrible. Stick with the ones who you can learn from as much as possible. If you have a poor attitude, it will shine through so forget about anyone going out of their way for you. The dirty little secret is that the attendings are not there for you and your education!!! Teaching residents comes a distant fourth after patient care, research, getting grants, and publishing. I had some great attendings and some very bad ones. However, I made it a point to learn something from all of them. Even if I were in a case, no one noting my existence, attending is being a jerk, etc., I still would study the way they did things and learned. Sometimes it was learning what not to do. So, residency sucks. Put on your big boy panties and deal with it.
”Teaching residents comes a distant fourth after patient care, research, getting grants, and publishing.” This is very true and an unfortunate statement. I am still not fully grasping/ accepting this until now considering how the residents do all the attending physicians' work for them while they relax all day then they refuse to give some time for residency teaching in the OR to order to keep their egos stroked during the long procedure. I thank you for showing me that even in the US, teaching residents is not an attending's priority even though residents do all his dirty work all day (and all night). I now have no regrets as to why I did not do my Residency elsewhere like in the US. Due to their lack of appreciation, I hate surgical residencies forcing us residents to depend on Attending Physicians for our surgical training.

I don't need an Attending Physician to teach me anything for most of my valuable time in specialties like Dermatology, Radiology, Psychiatry, etc., and even when I need him to teach me, it will be because he has to teach me to get his lazy ass work done. In surgical specialties, teaching you in ORs doesn't speed up slave work flow, it slows the Attending Physician down. In Dermatology, you can read most of what you need to know and the Attending Physician will have to teach you to keep the work flowing smoothly. This is not to mention how much more nice & benign Attending Physicians are in medical specialties compared to surgical specialties. You don't need to watch an Attending Physician for a whole 12 hour surgery showing off how gay and cool he thinks he is in medical specialties if he's not into teaching.

I the end, doesn't matter what you do if you do it well. If you do it well, the money will come. Quite honestly, I think you really need to go back a step and decide if medicine is what you really WANT to do.
You would be very unlikely to reach the average annual income of a Cardiothoracic Surgeon with a degree destined to set you up for failure like Family Medicine, ER, or Pediatrics. Were they to somehow make it, it would be because of business rather than their poor specialty of choice.

I understand that some Radiologists (top 10% of earners) can make more money than some Pediatric Cardiothoracic Surgeons/ Neurosurgeons (top 50% of earners) in the United States but that's not how statistics work. By statistical averages, the best Neurosurgeons (top 10% of earners) would certainly outearn the best radiologists (top 10% of earners) financially.
 

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Disturbing post. Please for the sake of any prospective patients do not be a neurosurgeon. You need to get your priorities straight and do some serious soul searching and self reflection—but not on car forums. At the end of the day exotic cars are just expensive toys and don’t mean shit
 

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Discussion Starter #13 (Edited)
That's my point, it wont apply as the US has a very unique type of payment system and a large country with rich and poor areas. So im guessing your area does not have socialized medicine?

There is only 24 hours a day, so you can only operate "THAT" much and see only "THAT" many patients. The high earners from "practicing" are essentially famous in their field (the ones that rich people/celebrities/cash paying people see). If you don't learn from them, you will be in competition from them. Either way a city can only support so many before everyone takes a pay cut.

If you want to look at it from a money type view only, you should check how much a doctor gets paid to do X procedure (not the cost of procedure because that usually includes anesthesia and hospital/facility fees).

so the factors will be pay, in terms of hours/$. A lot of neurosurgeons are on call a lot, get very little money from it unless there is a case. But it essentially ties you down as you are not totally free. Hard to watch a movie/go out of town etc. Location where you want to live and how much competition is there..... and you actually got to tolerate what your doing...…….big plans you have to figure out what business related entities you can enter seamlessly.

My orthopedics neighbors makes more off his surgery center/physical therapy/rehabilitation center than he does operating, but obviously his surgeries feed the other 2.... Things like that are extra income earners..... I don't consider stocks, or franchising a mcdonalds part of this as that's not related to your degree.....

In my opinion cosmetic derm is a great bang for the buck, great lifestyle and there is rarely an dermatology emergency (I mean real emergencies where you have to get up at 3am to figure out)
Radiology is also a good pay/work ratio and a lot of work can be do remotely.
What is socialized medicine? Is it the Insurance based system?
I agree that Dermatology is the best bang for the buck but is being an R1 Dermatology Resident better when most colleagues have finished their specialties training/ nearly finishing or is being an R4 Neurosurgery Resident better given that I don’t waste these years. I’m really worried about the wasted years. It will take me a year or two to get into Dermatology. I also might be overconfident about my ability to boost my board marks during the “stay at home period” to get into Dermatology.

The money I might lose from quitting Neurosurgery also concerns me a lot as I worry that Dermatology might be oversaturated with practitioners. I truly love dermatology as a specialty and I also love family life but I also need the money to easily afford a hypercar as a daily driver. I want to be nicer to increase my social circle and a hypercar with a fake modest attitude is what I need. I hate neurosurgery residency lifestyle. Fellows can have a good lifestyle. I can learn to tolerate ORs as an Attending Physician knowing how much I’m paid per hour. I still prefer dermatology but quitting your job is a tough decision considering how tough the job market is and also considering that I am leaving a very competitive specialty like Neurosurgery. Again also if I quit, 2 years will have been wasted and 1 to 2 more years are to be wasted with no guarantee for getting into Dermatology although likely.
 

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What is socialized medicine? Insurance?
I agree that Dermatology is the best bang for the buck but is being an R1 Dermatology Resident better when all colleagues have finished their specialties training or is being an R4 Neurosurgery Resident better given that I don’t waste these years. I’m really worried about the wasted years. It will take me a year or two to get into Dermatology. I’m also might be overconfident about my ability to boost my board marks during the “stay at home period”.

The money I might lose from quitting Neurosurgery also concerns me a lot as I worry that Dermatology might be oversaturated with practitioners. I need the money to easily afford a hypercar as a daily driver. I want to be nicer to increase my social circle and a hypercar with a fake modest attitude is what I need. I hate neurosurgery residency lifestyle. Fellows can have a good lifestyle. I can learn to tolerate ORs as an Attending Physician knowing how much I’m paid per hour. I still prefer dermatology but quitting your job is a tough decision considering how tough the job market is. Again also 4 years wasted.
As noted above, even more disturbing post. You need help. I'm outa here.
201209
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Discussion Starter #16 (Edited)
Correct. If the OP doesn’t understand the economics of how a doctor gets paid. This whole thread is moot.
I don’t need to understand facts (assuming that I don’t understand):

Neurosurgery:
The MGMA Physician Compensation Report has the average neurosurgeon income at $775,968. The median income is $704,170. The lowest paid neurosurgeon earns at least $350,000 while the top 10 percent make up to $1,229,881 a year.

Dermatology:
The 2013 Dermatologist Compensation Report released by Medscape reveals that:
12% of dermatology doctors earn annual salaries under $100,000
5% of dermatologists earn between $100,000 and $150,000 a year
5% earn from $150,000 to $200,000 a year
18% make between $200,000 and $250,000 a year.
12% of the dermatologists included in the survey are paid between $250,000 and $300,000 annually
11% report an annual pay in the range from $300,000 to $350,000.
9% of the dermatologists surveyed make between $350,000 and $400,000 a year
11% have earnings between $400,000 and $500,000 a year
8% earn from $500,000 to $600,000 a year
7% have an annual income in the range between $600,000 and $700,000
2% are paid between $700,000 and $750,000 annually.
 

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I don’t need to understand facts (assuming that I don’t understand):
good luck with your data, as its pretty much meaning less to an individual if you dont understand what each specialty does to earn it.
its obvious you don't know how a surgical specialist works and bills.
 

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Discussion Starter #20 (Edited)
good luck with your data, as its pretty much meaning less to an individual if you dont understand what each specialty does to earn it.
its obvious you don't know how a surgical specialist works and bills.
If you have the time to share knowledge/ to mention something helpful, kindly do. Life is a learning process. I’ll happily fill in these knowledge gaps over the next years and bill my patients /their insurance accordingly. I don’t think that I would need to know now at my level as a Resident how an Attending Physician successfully takes the money from the patients/ their insurance. For now, I will focus on this life’s decision on whether to continue Neurosurgery or to quit for Dermatology considering all the aforementioned possible setbacks and concerns. Forum members‘ life experience is what I need to make this decision. Factors such as ”how a surgical specialist works and bills” are important for making this decision.
 
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