The Fresh New MS1s

With my birthday being the other day, and seeing Rachel Thies  in her fresh new short white coat, I’ve really taken a pause to reflect on my life journey.

First I would like to say congrats to all of the MS1s who have been accepted this year.  You have gotten through the bottle neck of the medicine journey and you have a long tough road ahead.

Med school is a rough time.  Looking back on it, I have to say it easily was not one of the most fun times in my life.  The theme of my medical school journey probably was “put your head down and just keep moving.”  As new medical students, please keep this in mind.  So far my residency has been totally worth the tough and long road of medical school, and I anticipate an awesome 6 years here in Cincinnati.

Anyways, a bit of advice for incoming medical students, don’t worry about your speciality.  You will worry about it constantly anyway, but I promise you it will come with time and most likely you’ll be happy in a handful of different specialties.  Second, you will have time to do things.  Your life isn’t over.  I’ve arguably (according to some of the reports you read online) have one of the busiest lives known to man.  Neurosurgeons are known to work 100 hour work weeks (not that I am, I follow the 80 hour work week religiously @ACGME), yet I still have time to type away on my blog and update my website.  You’ll have time too.  Also, read my previous posts about the school and what’s to come.  You’re going to have a good time.  Don’t forget to put your head down and plow through it.  And if anyone has any questions feel free to email me.  Shawn.Vuong@uc.edu

 

A Different Kind of Busy

Sanford SOM Curriculum

Sanford School of Medicine Review [Part 2]

Most Competitive Specialties of the 2010 Match — for US Seniors

According to the NRMP, here are the most competitive specialties for the 2010 match Table 13 and Table 14 in the Results and Data 2010 Match.

Top Ten Most Competitive Specialties – Based on positions per US Senior 
— Positions per US Senior (aka allopathic graduate), is making the assumption that the specialty is more competitive due to the fact that many more seniors apply for it in relation to the number of actual positions.  
Rank Specialty Name Positions per US Senior
#1 Plastic Surgery (Integrated) 0.6
#2 Vascular Surgery (Integrated) 0.7
#3 Orthopedic Surgery 0.8
#4 Dermatology  0.9
#4 Neurological Surgery 0.9
#4 Otolaryngology 0.9
#7 Radiation Oncology 1.0
#7 General Surgery 1.0
#9 Radiology – Diagnostic 1.1
#10 Emergency Medicine 1.2

***Please note :: Thoracic Surgery (integrated) and urology were left out of this table since they only offer 10 positions and 7 positions respectively in the NRMP main match.

Top Ten Most Competitive Specialties – Based on percent of unmatched US Seniors  
— Percent of unmatched US Seniors is a good barometer of competitiveness.  This calculation takes only those students who ranked one specialty, then figures out the percent of those who did not match into the said specialty.

Rank Specialty Name Percent
Unmatched
#1 Plastic Surgery (Integrated) 26.5%
#2 Dermatology 25.1%
#3 Orthopedic Surgery 19.6%
#4 General Surgery 15.7%
#5 Otolaryngology 15.4%
#6 Neurological Surgery 15.1%
#7 Radiation Oncology 14.5%
#8 Physical Medicine & Rehabilitation (PM&R) 10.2%
#9 Obstetrics and Gynecology 8.6%
#10 Radiology – Diagnostic 6.5%

For comparison sake, Family practice and Pediatrics have a 2.5% unmatched rate for US seniors

USMLE Step 1 – 2010 Percentile Score

Hello everyone.  I received a phone call from a fellow medical student about determining a percentile score, and I told this person that it could be possible to figure out the percentile score this year from the information that the NBME gave us.

According to my score report (and others based on the information I’ve gathered), the NBME states:

“This score is determined by your overall performance on Step 1.  For recent administrations, the mean and standard deviation for first-time examinees from U.S. and Canadian medical schools are approximately 221 and 24, respectively, with most scores falling between 140 and 260.  A score of 188 is set by USMLE to pass Step 1.  The sandar error of measurement for this scale is six points.”

Making the assumption that USMLE scores follow a “normal (Gaussian) distribution” we can figure out the percentile grade.  Of course I do not know how big of an assumption I am making by saying that USMLE scores follow the normal bell curve.  Please note I am not a statistician.

So lets assume you have a three digit score of 245 on the Step 1 and would like to know percentile you fall into (I picked 245 for easy math – I was not fortunate enough to score this high).  As we know from our Step 1 studying, 68% of the population falls into the area of one standard deviation on both sides of the mean.  That means that 34% of the population falls on the upper half of this mean.  The mean on a percentile graph is of course 50%.

So we can say that if you received 24 points away from the mean in either direction (because that is one standard deviation according to the NBME) then you are 34% away from the mean in the same direction.  In this case if you scored a 245 then you are exactly 24 points above the mean.  We can also say then that you are 34% above the 50th percentile putting you into the 84th percentile.  Any score can be figured out using ratios of this.  Of course I realize my math is probably wrong, but this will give a person an estimate.

Keep in mind, my math could be TOTALLY wrong, but it seems to work out in my brain.  Here is a table with my calculated percentile scores.  Any corrections on my math would be appreciated.

Score Percentile (Estimate)
149 <1%
173 2.3%
197 16%
209 30%
221 50th Percentile 
233 70%
245 84%
269 97.7%
293 99.9%

[Similar Post – Check Out Real Board Scores for Step 1]

First Day of My Third Year

Today was my first day of the third year.  To be fair it wasn’t a true first day, so much as an orientation day.  This post is going to be a couple random thoughts about the day.

First off, I hate orientation days.  Being the kind of person who likes to jump right in and get my hands dirty – a learn as I go kind of guy – orientation days seem to drag on and are extremely boring from my perspective.  The “need to know” things in an orientation day can usually be summed up in maybe an hour.  They could just tack this to the beginning of the first day and call it good.

Another thing I hate about orientation days are the ice breaker and get-to-know-you games.  Today we had at least four different speakers have us go around the room, introduce ourselves, tell them where we were from, and a little about ourselves.  Doing it once is more than enough.  By the fourth time you feel like strangling a puppy.

Next random thought, I have my own business cards.  The program gives them to us to distribute.  How cool does that make me?  Admittedly, probably not very cool.  But I feel a ton cooler.  Also, I have a pager now.  I guess I’m important enough to page and give out business cards.  Whoa.  Moving on up the ladder.

Yankton, SD has over 65 practicing physicians.  Yankton county only has a population of 21,000.  I was unable to find out the size of the catchment area of the hospital.  But that seems like an impressive number of physicians for a community this size.  Also, while talking to the physician recruiter, she said that they are currently looking for family practice doctors, internal medicine physicians, endocrinologists, urologists, general surgeons, and 3 invasive cardiologists.  I asked if the Yankton community even had the resources to support three interventional cardiologists, and she stated that they had all the infrastructure in place, they could hire and support all three tomorrow.  I was shocked.  Not only does Yankton have 65 practicing physicians, but also it could support many more.  Crazy.

Talking about physicians, a neurologist has just started practicing with the large multispecialty group in the last two months.  I was excited to hear this, with my interest in the neurosciences.  Also, the hospital plans on upgrading their MRI to a 3 Tesla with fMRI capability, in conjunction with research funding.  So, fMRI research will be taking place right where I’m studying.  That is exciting.

We will be getting a TON of hands on experience.  Just recently a student interested in surgery who has been going his third year in Yankton, was allowed to do the left side of a hysterectomy under close supervision of an attending surgeon.  In what other medical school could a person get that kind of hands on experience as a medical student?  No where.

We will be required to do 42 history and physicals with a problem list – over dictation (with our own dedicated transcriptionist) over the course of the 3rd year.  We will be required to assit with twenty vaginal deliveries, assist with five c-sections, do twenty new born exams, and twenty-five well child exams.  There are medical students in the United States who finish their third year having never assisted in a vaginal delivery.  And here at SSOM, 20 deliveries is just the bare minimum requirement, some students log way more.  I wonder how many babies the Ivy league medical students deliver?

While orientation day was boring, the information I received over the course of the day made me super excited to get this year started.  It has a LOT of potential.

Sanford School of Medicine – Match Statistics

One thing that I learned sometime during my Pre-Med days was to look at match statistics of schools to determine how well they do at training their students.  I thought that was good advice.  Obviously, how well a school does training their students should correlate to a better match rate.  I mean it’s exactly like looking at how well certain colleges place their students into careers.

So, I took that to heart.  Now, I’ll be the first to admit, I wasn’t exactly afforded a large choice between medical schools.  What I mean to say is, I didn’t get into a ton of medical schools.  But hey, that doesn’t matter now does it?

So, before I even started medical school, I took an interest in the matching statistics of the schools I was applying to.  And after I was accepted at the Sanford School of Medicine (SSOM), I really concentrated on their matching stats, and to be honest we do pretty well.

I have compiled the matching statistics from SSOM since the year 2000 in a spread sheet, and I have found some interesting trends.

Match Stats


Since the year 2000 (including the 2010 match) – we have graduated and matched 545 students from SSOM with 93 going into Family practice which is 17.1% .   Compared to the US match rate of 7.4% matching into Family Practice (and only a 3% behind the leader), I would say that SSOM is doing pretty well meeting it’s mission.  And out of all the students who graduated since 2000 almost 45% of them have entered a primary care specialty (which would include Family Practice, Internal Medicine, Pediatrics, and Psychiatry).

Our medical school has also done a great job matching students into very competitive specialties as well. Dermatology has long been known as one of the most difficult specialties to match into.  Yet, three students from a class of 50, matched in both the 2007 and 2008 match.  Or to put it another way, 6% of our class those two consecutive years matched into a specialty in with only 1.8% of medical students are able to match (according to the 2009 match statistics).

While most of our students match in the midwest, some have matched into some of the most well known universities in the country including Baylor, Cleveland Clinic, Dartmouth, Emory, Massachusetts General, Mayo, UCSF, Rochester, Vanderbilt, Yale, and others.

So, if you’re a Pre-Med student, don’t worry if you don’t get into the Ivy league schools.  State schools, even little South Dakota, can help their students match into competitive specialties in well known programs.

——————
Top Ten SSOM Specialty Choices

  1. Family Practice
  2. Internal Medicine
  3. OB/GYN
  4. Anesthesia
  5. Pediatrics
  6. Psychiatry
  7. Emergency Medicine
  8. Radiology (Diagnostic)
  9. Pathology
  10. Orthopedic Surgery

Top Ten SSOM Match Locations

  1. South Dakota
  2. Minnesota
  3. Iowa
  4. Nebraska
  5. Wisconsin
  6. Kansas
  7. Michigan
  8. Missouri
  9. Texas
  10. Illinois 

Sanford School Of Medicine – Early Clinical Exposure

One reason I chose to come to the Sanford School of Medicine here in South Dakota, is because of the early exposure to real clinical medicine.  Sanford SOM is known (by those in the area) for it’s amazing clinical experience especially in the MS3 and MS4 years.  The medical students at this school work almost exclusively one-on-one with attending physicians.  Usually there is no senior student, intern, junior resident, senior resident, chief resident, or fellow blocking the third year medical student’s view of the action.

But little is known about the early clinical exposure in the MS2 year.  Here at the Sanford SOM, the second year classroom schedule ends at the end of March.  A transition to the clinical world takes place over the end of March and early April, and then the real fun begins.  Each MS2 gets paired with a rural family practice physician somewhere in the state of South Dakota, and we spend an entire month with them.

Almost all of us were exposed to serious trauma, OB/GYN, geriatrics, pediatrics, general medicine, emergency medicine, and some even were scrubbing into surgeries.  I personally was rounding on hospital patients, putting in stitches, doing history and physicals, seeing clinic patients, seeing nursing home patients, and assisting with surgery.

To give you an idea of how much exposure we had, I personally logged in over 200 patient encounters.  Some of these include:

  • Ear aches
  • Multiple Myloma (Cancer)
  • Well Child Visits
  • Physicals
  • Abdominal pain
  • Pneumonia
  • Allergies
  • Head trauma
  • Broken ankle/foot
  • Knee injury
  • Elderly falls
  • Vertigo and Dizziness
  • Constipation
  • Hypothyroid
  • Stroke
  • Heart Attack
  • Congestive Heart Failure
  • Flu
  • Breast Lump
  • Headaches
  • Low Back Pain
  • Smoking cessation
  • Pregnancy
  • Diabetes
  • Warts
  • Depression
  • Bipolar Disorder
  • Hypertension
  • Syncope
  • Hemorrhoids
  • Strep Throat
  • Hernia
  • Seizures
  • Cough
  • Acid Reflux
  • ADHD

I was also lucky enough to get to do some cool procedures too!

  • Interpret X-Rays, CT scans, and MRIs
  • Assist with ultrasound of the bladder, cartoid arteries, and pregnancy
  • Put in stitches
  • And scrub in and first assist on 8 surgeries including open appendectomies, laproscopic cholecystectomies, C-sections, and a hysterectomy.  
So, here’s a taste of the clinical exposure we get at this medical school.  If you’re interested to read more about what I have to say about the Sanford SOM, read my medical school review Part 1 and Part 2.  It was an awesome first clinical experience, and I cannot wait to get started with the 3rd year!

Medical Students Have To Learn Sometime

[The dude in this picture is just a random guy I googled, not the real patient talked about in this post]

Another medical student and I were hanging around the emergency room at a small town hospital the other day.  The weather had been particularly nice that day and a man decided to fix some of the gutters and siding on his home.  So he climbed up his ladder and started working, but his guardian angel must have taken a coffee break and his ladder broke.  The man fell 15 or so feet down to the concrete, and was transported by ambulance to the ER.

Unfortunately this man had a large laceration across his forehead, and another long his arm.  Lucky for us medical students, this man had two large lacerations that required stitches.  For story completeness – this guy was completely stable and had absolutely no life-threatening injuries.  The lacerations were the only injuries he sustained as a result of his fall.

The doctor working in the ER with us decided this was a great opportunity for us to practice our suturing skills, and so the doctor told the other medical student and I to come over “and assist him with stitching up.”  The man’s wife did not like the sound of that at all, and she asked if the students would be allowed to put in the actual stitches.  The doctor told her that we would, under his close supervision.  The wife wasn’t convinced that this would be ok.  So she asked if there was ANY way that the doctor could call in another physician to help “assist” with the stitches.  He said that the other doctors were too busy to be called in for this, and the medical students were available and have had plenty of training in this type of procedure.  The man’s wife told the doctor that she really didn’t want students practicing on her husband, and the doctor reassured her that we have had lots of training and that medical students can do this.

It felt weird to be in the middle of that disagreement.  On the one hand, I completely understand the wife’s concern of having medical students essentially “practice” on her husband.  Yes we’ve had 6 years of post high school training, but in all honesty probably less than 5 hours of suture only training at this point.  But on the other hand, us medical students need to practice on someone.  If you only had the most experienced people do the job every time, then how would you train the next generation?  Also, if I completely mess up and a suture falls out, then we can always put another in or just let it heal without the missing stitch.  It won’t make a big difference.  I also understand that the wife may not have known that this was a fairly low risk procedure on the grand scale of things, and so I can understand where she’s coming from.

Yes we have to learn sometime.  If everyone says no to medical students, then there will never be an experienced group of physicians.

How Am I Choosing A Specialty?

After reading the Ultimate Guide to Choosing a Medical Specialty by Brian Freeman, more than three times, scouring the internet for hints and tips, and asking every physician I’ve encountered for advice in picking a specialty, I think I may have figured out a couple things about how I am currently going about picking my favorite specialties.

At one time I had read somewhere that the best way to really chose a specialty is to sit down and think of the real reasons that you went to medical school.  This may sound stupid or naive to some, but I went to medical school to save lives.  Seriously, that was my real over-arching reason for pursuing this career.  Now, I realize that most of what physicians do isn’t saving lives, in fact most physicians just make patients lives better by managing chronic disease.  Other reasons I decided to go to medical school were to help people, have an intellectually challenging career, job security, and a salary where I know I’d be able to easily afford the necessities of life without ever worrying about pinching pennies.  Prestige, respect, reputation, and community status played a far lesser role in my decision to become a doctor.

In this context, I’m going to try to objectively think about which specialties actually do some “life-saving.”  Others could probably add some to this list, but this is the best I can do off the top of my head.

  • Emergency Medicine
  • Cardiology/Cardiothoracic Surgery
  • Neurology/Neurosurgery
  • General Surgery
  • Internal Medicine/Pediatrics
  • Anesthesiology
  • OB/GYN
  • Psychiatry 

Out of this list, there is not one acute life-threatening scenario that I can think of that this group of specialist would not be able to handle.  I am assuming of course that General Surgery can amputate gangrenous limbs and handle all but neurologic and thoracic trauma surgery cases.  One could even argue that this list could be narrowed down even farther.  But I think this is a good representation of specialties that work directly on patients in acute situations, that can and do make life and death decisions and provide life-saving treatments.  (Again, I’m just throwing this up in the 10 minutes it takes me to throw together a blog post and may be missing some – and I my mind is just racing right now so I’m just throwing down what I can).

As you can see at this point, a large portion of these make up my top list of specialties I am regarding as my top choices.

Another tip that many physicians have suggested is to decide whether one is a surgeon or a medical physician.  I’ve sat down and pondered this over and over.  Am I a surgeon or am I medical?

Over the last couple years this question has always been in the back of my mind.  Just in the last couple months or so, I think I am on venturing over to the surgery side of the fence.  After I made what I thought was a huge proclamation about myself and my future, close friends of mine said things like “yeah, I could see you as a surgeon.  I figured that’s what you’d probably do.”  And so, I wondered, where were these all knowing friends earlier?

I enjoy working with my hands.  I enjoy little things like shoveling the driveway, washing the dishes, or putting walmart furniture together.  While these are not things I jump for joy doing, I do enjoy them a lot more than mental exercises of the same type.  For example, I could do without doing bills, balancing my check book, organizing my [anything].  Are these examples enough to completely push me onto the surgery side of the fence?  No I don’t think so, but it does start to build a case towards surgery in my opinion.

There are many other things I think have helped push me in that general direction.  I thrive on a chaotic environment.  I enjoyed the hands on part of my research projects (little animal surgeries).  I like playing musical interments (guitar & violin) but I couldn’t care less about musical theory.  I am a visual individual.  I like pictures, charts, and anatomy.  I enjoy figuring out problems and then doing something about them.  I am a self proclaimed doer and I don’t like to wait around for things to happen.  I like physical puzzles like the rubik’s cube more than riddles.

Is all that enough to put me directly into surgeon land?  Maybe.  Maybe not.  But to me, it does make for a case definitely towards surgery in my opinion.

In medical school, I’ve enjoyed my OR time so much that I have been seeking out surgery shadow time in my limited free time.  But at first I was unsure if this was because anything seemed more interesting that sitting in class all day or because I was genuinely interested in surgery.  But now I’m sure, that some procedural specialty is in my future.

There you have it.  My overall thinking process on how I’ve been trying to narrow down my specialty choices.

What Do Doctors Make?

Great question.  While it’s easy to just google and find something, here is some American Medical Group Association referenced data compiled after a compensation survey in 2009.  This information seems legit because I got it from the U.S. Dept. of Human & Health Services.

Medical Specialties
Allergy $241,138
Cardiology $398,034
Cardiology – Branch ** $446,891
Cardiology – Cath Lab $471,746
Cardiology – Echo Lab/Nuclear $414,500
Cardiology – Electrophysiology Pacemaker $437,000
Critical Care Medicine $268,250
Dermatology $350,627
Dermatology – Branch $334,135
Dermatology – Mohs $516,468
Endocrinology $212,281
Family Medicine $197,655
Family Medicine – Branch $187,727
Family Medicine with Obstetrics $202,047
Family Medicine with Obstetrics – Branch $188,785
Gastroenterology $389,385
Gastroenterology – Branch $447,184
Genetics $193,344
Geriatrics $211,425
Hematology & Medical Oncology $315,133
Hematology & Medical Oncology- Medical Oncology Only $248,623
Hospitalist $211,835
Hypertension and Nephrology $246,049
Infectious Disease $222,094
Intensivist $273,520
Internal Medicine $205,441
Internal Medicine – Branch $189,187
Internal Medicine – Office Only $168,133
Neurology $236,500
Occupational/Environmental Medicine $214,146
Ophthalmology – Medical $231,493
Orthopedic – Medical $265,345
Pain Management – Non-Anesthesiology $260,350
Palliative Care $186,924
Pediatrics & Adolescent – Adolescent Medicine $205,395
Pediatrics & Adolescent – Allergy $195,973
Pediatrics & Adolescent – Branch $183,892
Pediatrics & Adolescent – Cardiology $244,944
Pediatrics & Adolescent – Developmental Behavioral $170,769
Pediatrics & Adolescent – Endocrinology $185,901
Pediatrics & Adolescent – Gastroenterology $236,700
Pediatrics & Adolescent – General $202,832
Pediatrics & Adolescent – Hematology/Oncology $205,999
Pediatrics & Adolescent – Hospitalist $167,953
Pediatrics & Adolescent – Infectious Disease $199,165
Pediatrics & Adolescent – Intensive Care $256,913
Pediatrics & Adolescent – Internal Medicine $208,838
Pediatrics & Adolescent – Neonatology $265,000
Pediatrics & Adolescent – Nephrology $217,767
Pediatrics & Adolescent – Neurology $209,955
Pediatrics & Adolescent – Pulmonary $176,974
Pediatrics & Adolescent – Urgent Care $196,934
Physical Medicine & Rehabilitation $236,500
Psychiatry $208,462
Psychiatry – Child $214,304
Psychiatry – Inpatient $218,472
Psychiatry – Outpatient $184,946
Pulmonary Disease $278,000
Pulmonary Disease – Sleep Lab $259,444
Reproductive Endocrinology $317,943
Rheumatologic Disease $219,411
Sports Medicine $214,249
Urgent Care $215,625
Surgical Specialties
Bariatric Surgery $360,000
Cardiac & Thoracic Surgery $507,143
Cardiovascular Surgery $509,302
Colon & Rectal Surgery $366,895
Emergency Medicin
e
$267,293
Emergency Medicine – Pediatrics $217,551
General Surgery $340,000
General Surgery – Branch $309,750
Maternal/Fetal Medicine $394,121
Neurological Surgery $548,186
Neurological Surgery – Pediatrics $612,851
OBGYN – General $294,190
OBGYN – Branch $280,606
OBGYN – Gynecological Oncology $406,000
OBGYN – Gynecology only $218,607
OBGYN – Obstetrics $301,773
OBGYN – Urogynecology $301,777
Oncology – Surgical $337,475
Ophthalmology $325,384
Ophthalmology – Branch $277,975
Ophthalmology – Pediatrics & Adolescent $283,853
Ophthalmology – Retinal Surgery $443,827
Oral Surgery $380,500
Orthopedic Sports Medicine $484,320
Orthopedic Surgery $476,083
Orthopedic Surgery – Branch $483,400
Orthopedic Surgery – Foot & Ankle $399,445
Orthopedic Surgery – Hand $465,006
Orthopedic Surgery – Joint Replacement $580,711
Orthopedic Surgery – Pediatrics $424,367
Orthopedic Surgery – Spine $641,728
Orthopedic Surgery – Trauma $465,773
Otolaryngology $365,171
Otolaryngology – Branch $343,698
Otolaryngology – Head & Neck Surgery $334,250
Pediatric Surgery $400,591
Plastic & Reconstruction $388,929
Thoracic Surgery $405,842
Transplant Surgery – Kidney $348,000
Transplant Surgery – Liver $433,333
Transplant Surgery – Medical $354,158
Trauma Surgery $399,558
Urology $389,198
Urology – Branch $317,322
Vascular Surgery $403,041
Radiology/Anesthesiology/Pathology Specialties
Anesthesiology $366,640
Anesthesiology – Pain Clinic $379,000
Dermapathology $333,250
Diagnostic Radiology – M.D.s Interventional $478,000
Diagnostic Radiology – M.D.s Neuro-Interventional $458,187
Diagnostic Radiology – M.D.s Non-Interventional $438,115
Diagnostic Radiology – Mammography $513,402
Nuclear Medicine (M.D.s Only) $386,506
Pathology – M.D.s Anatomic $285,173
Pathology – M.D.s Clinical $272,500
Pathology – M.D.s Combined $344,195
Radiation Therapy (M.D.s Only) $413,518
Midlevel Providers
Dentistry $167,389
Podiatry – Medical $190,596
Podiatry – Surgical $232,121
Podiatry – Surgical – Branch $175,565

* This information was obtained from the 2009 Medical Group Compensation and Financial Survey published by the American Medical Group Association® (AMGA). For further information, visit AMGA’s Web site at http://www.amga.org/

** Branch is defined as: A physician who practices at a satellite clinic or office removed from the main campus and may be subject to different practice patterns and productivity standards.

A couple notes about this chart, first I didn’t know that according to the government Emergency Medicine is a surgical specialty and being a dentist makes one a mid-level provider.  I also didn’t find any statistics related to this chart.  So I am unsure if survey responses over/under represent a certain region or demographic.  Also, unsure if survey responses are from a fair number of new, current, and soon-to-be retiring practitioners – as the point of one’s career would make a large difference on current income. Next, I do not know if these compensations take into account any physician owned medical building or property (ie: physician hospitals, physician owned MRIs, etc).  Lastly, I couldn’t find out if this was net-pay or gross pay or before malpractice premiums pay or something other than those.

Average Take Home
Medical Specialties — $252,106
Surgical Specialties — $390,866
Rads/Anesthesia/Path — $389,041
Mid-Level Providers — $191,418

As I looked at this whole table, I was a little surprised.  Not really by the amount physicians made, I had a good idea already, but the fact that just yesterday I posted that physicians are having a hard time keeping their practices open.  This data just by itself strikes me as odd that physicians cannot make enough money to keep practicing in some instances.
This makes me wonder, how much are those student loan payments?  I am figuring that I’ll be close to $200,000 in debt post-med school.  By bringing home a salary of $160,000/year, am I really not going to be able to pay off loans, pay for a family, and pay for a decent mortgage?

Something doesn’t seem like it connects here.  Either student loan repayment is VERY expensive (which I guess I wouldn’t really be too surprised by that – the banks definitely know how to steal everyone’s money) or these surveys aren’t accurate in some way. Or it could be something else entirely.  Who knows?