Note: This post is part one of a two-part series.

You’re a smart person on paper - you got into medical school. You may have done well during your four year stay too, but now comes the ultimate test. Let’s turn away from focusing solely on medicine for a bit and think about maximizing your income no matter what specialty you choose.

Work Smarter Not Harder

Most people don’t like to “work more for less.” Could this be a reason for the decline in interest of the primary care specialties? Without a doubt it is.

Imagine that you’re standing in between two trees. On the lowest branch of one tree is a $100 bill hanging within arms reach. On the highest branch of the other tree is another $100 bill, which is only reachable after an exhaustive climb. Which one would you choose if you could only choose one? Most people would just walk right over to the low-hanging branch, pluck the $100 bill and be on their way. This is not being lazy. This is a very basic example of working smart.

You need to start thinking like this no matter what specialty you choose. Do you want to put in more time and effort for the same monetary gains?

Your Time Has Value

Every minute of your day has value. Most people exchange their time for money in the form of work, and this time is on sale.

How much is your time worth? Would you rather spend 80 hours per week to make $5000 or 40 hours per week for the same amount of money? Those that correctly choose working 40 hours per week for $5000 value their time more than those who don’t care. Above all, you should ultimately do what you love. Just try to make sure that your time is never on sale.

Easier said than done? Not really. Let’s take a look at passive income and how you can turn your sale-priced time into a premium commodity.

Start Thinking Passively

I’ve always been amazed at the number of people who think you can only get paid while at work. This misconception has been passed down from generation to generation, and it’s almost a sin to think otherwise.

The people who think this way (and thus spread the false message) are the same people who only get paid while at work. They don’t know any other way. Don’t let the mind conditioning take you over.

There’s a reason why the world’s top earners are consistently business owners. They have developed passive income streams. Passive income simply means that you are getting paid whether you actually work or not. With my business I get paid while I sleep, at the movies with my wife, while playing video games, or at a week-long vacation on the beach (and I’m not talking about paid leave here). This is the best income to have.

Let’s take a look at an example. Assume that your passion is family medicine. Family medicine is one of the lowest income specialties of medicine. I’ve already mentioned that primary care specialties are seeing massive reductions in the number of students entering those specialties. I believe this is due to decreases in reimbursements which ultimately leads to decreases in compensation, among other things.

For the average family doc, their time is on sale. This is because they are not working smarter. In fact, they are working harder for lower reimbursements. How can we turn their time, which is currently on sale, into a premium commodity?

Stay tuned for part two in this series, and I’ll explain how.

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What are you passionate about? Is it really medicine, or is medicine just a guaranteed way to make a nice buck?

If you were to win $100 million in the lottery tomorrow, would you continue to do the same things you are doing now, or that you have planned to do in the future?

The question posed above is important. It’s the “truth” question. Be truthful with yourself and you’ll discover if you’re really passionate about medicine, your job, or whatever it is that you do to put food on the table.

For me, I would definitely continue along the same path that I’m on right now if I won the lottery. I absolutely love the things that I am doing, and I would do them for free if I had to. It is certainly nice that it puts a decent paycheck into my hands each month, but that’s not the point. I know I’m in the right place.

My grandfather never went to college and worked as a machinist in a plant for a good portion of his life. Very typical blue-collar work that is common for my family. He couldn’t tell me about complex chemical formulas, or the physiological changes of the human body during pregnancy. Instead, he taught me how to fix lawnmowers and cars when they broke down, and how to do odd jobs around the house.

Despite that fact that the had very little formal education, my grandfather was very “street smart.” He had lived life, and realized the mistakes that he had made. Mistakes that he could look back on and see, but that he couldn’t do much about for himself personally. He truly cared for me and wanted to change my life, to share with me some shred of information so that I could have something that he never did. One day before he passed away, he did just that.

“Find something that you love doing so much that you would do it for free, and then find a way to make a living doing it. If you can accomplish this, you’ll never work a day in your life.”

Take that to heart. I did, and it truly did change my life.

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I found this thread today, where a student is leaving medicine. I have to say that I support BrendaB 100%.

I just want to say to please, please make sure you know what you’re getting yourself into. In this thread, BrendaB deals with the “was it a waste?” question rather nicely.

This is a topic that we’ve visited here before at MSH, but the decision is always as tough as nails. This is a great thread for those of you still contemplating getting started in medicine or those that are unhappy and looking for an outlet.

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I thought it would be fun to see what all I could dig up using Google and the search query “gunner” “medical school.” Here is what I found. Enjoy.

• Connect! An ‘Anti-gunner’ Battle Cry
• Gunner Bingo
• Joe Wright: ‘Gunners’ Blasting their Fellow Med Students
• True Tales of Medical School: The Gunner
• Do you love or hate med students?
• 15 Types of Medical Students [PDF]
• Medstudentgunner.com - [A pitiful attempt at a website]
• Man Your Battlestations

Prove to me that your Google search powers are superior to mine, and post any kick-ass gunner links that you find or that you may know of. I know there’s more out there.

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Most students go to medical school because they want to care for patients in the traditional sense. This includes physical exams, following up on labs, making treatment decisions, and a whole lot more.

Unfortunately, most medical schools don’t promote Pathology as much as they should. It’s not part of the core rotation curriculum during your junior year, and if you want to see what a pathologist actually does, you’ll need to set a block of time aside for an elective rotation as a senior student. Despite this, I do think that people are catching on.

If you haven’t given pathology some serious consideration, here is why you should:

1. No Patient Contact

You get to work with people, it’s just that they are other doctors. You are the “doctor’s doctor.” There is no rounding, no morning CBC to follow up on, no SOAP notes, and no physical exams at 5:30 am. Pages from the nursing staff are eliminated. Did that chest X-ray not get done this morning even though it was written for? Not your problem.

2. Good Hours During Residency

You can sit back and really appreciate a normal work day even during residency in most pathology training programs. As Panda Bear mentions, pathology comes very close to 40 hour work weeks even during training. Outside of dermatology and perhaps opthalmology, this is pretty hard to come by.

3. The Money Is Great

Pathologists get paid extremely well, especially considering the amount of time that they work. Salary data is from the Modern Healthcare Physician Compensation Review [PDF], and includes several data sources per specialty. According to the image to your right, the average annual salary for pathology is $254,398.

4. Almost No Call

What little call you’ll experience in pathology can all be done from home. I’ve never talked to any pathology attending or resident who has to take in-house call. The work just doesn’t require it. The dreaded “q3 call” won’t even be in your vocabulary, and you’ll cringe as you see residents in other specialties getting killed by a brutal call schedule.

5. Laid Back Work

Where else can you spend every other day or so with a nice cup of coffee getting your work done as you look into a microscope? Need to look something up or do some reading? You have time. None of the residents in pathology that I’ve ever spoken to relayed any feelings of being “rushed” or “not having enough time to complete work.” The work is laid back, and so are the people that go into pathology to begin with.

Don’t Give In To Stereotypes

I think too many medical students see pathology as a “weird” specialty. Students have been stereotyping specialties ever since they began medical school. As mentioned earlier, students don’t see pathology for what it is, but instead look at it as “nontraditional medicine.”

Don’t give in to these stereotypes and feel that you have to practice traditional medicine in order to be a physician. See specialties for what they are, and realize that you too can have a good life.

Don’t always try to read between the lines. The writing is on the wall.

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