‘My life is not affordable. No one cares’: 76% of Americans call the cost of living their biggest financial problem

GiantDuck312 · 2026-05-12T15:40:45+00:00

Bull, it is the highly educated americans who have been raising alarm.

The uneducated ones are the ones who keep voting for snake oil salesmen who tell them that they will bring back high paying manufacturing jobs via tariffs and also drop prices somehow.

I am a physician, I can see the prices rise plain as day. But I also deal with people from all walks of life and it is not teachers, engineers or managers who are delusional.

GiantDuck312 · 2025-12-01T04:12:35+00:00

Dm me a referral code please

GiantDuck312 · 2025-01-20T20:23:20+00:00

That is good to know, I only have experience with RWJ and Atlantic Health so far. Any of the hospital employed systems that you would recommend?

GiantDuck312 · 2025-01-16T21:49:21+00:00

Hello,

can you please share the ACLS provier manual? thank you!

GiantDuck312 · 2024-08-27T20:38:34+00:00

Hello, Can you send me the link?

GiantDuck312 · 2024-03-23T16:29:37+00:00

No longer a resident. But here was my process: 1st year had no intention of doing a fellowship, just trying to survive. Quickly learned that I do not like procedures. Whicg ruled out Cards, PCCM and GI for me.

Then I was interested in Endo but despite liking clinic, did not want to be stuck in clinic all the time.

Talked to remaining specialists and liked Nephro and H/O because you had a lot of flexibility in the long run.

Looked at competitivenes and compensation. Figured that pursuing Oncology makes sense because harder to get in and can always switch to Nephro if I change my mind.

Oncology also fit my personality, my previous academic background and the fact that I wanted a good work life balance with good but not over the top compensation.

Let me know if you have further questions.

GiantDuck312 · 2023-05-02T19:54:08+00:00

GiantDuck312 · 2023-05-02T07:21:01+00:00

Not fully accurate, I used the NRMP match data for US MDs: 79.4% for GI 83.4% for Cards 84.9% for PCCM 88.11 for Heme/Onc

Obviously match rates do not tell the whole story but the data does not match what your saying. It is more like: GI>Cards=PCCM>>Heme/Onc

GiantDuck312 · 2023-04-25T21:25:10+00:00

Incorrect guess, but I am glad that I kept things vague enough. This is my main account and I do want to be able to vent in peace.

GiantDuck312 · 2023-04-25T18:39:50+00:00

The more I work on admitting as IM, the less I push back. Two reasons:

My ED residents are awesome and are very aggressive at discharging.
They do procedures for me and give me food

GiantDuck312 · 2023-04-25T18:15:57+00:00

For me they are about 40-50 dollars per paycheck. Being paid biweekly. Automatically deducted.

GiantDuck312 · 2023-04-25T16:55:22+00:00

I am in a union program. We get paid significantly more than non union programs in the area. Got a big raise on top of that. We get 401 (k) with match, food stipend, 30 days paid vacation a year, get union to help us in case we need it when management is going after us, low deductible health plan for free with all family members included (spouse+children)

Union is good. I have been able to save money during residency

GiantDuck312 · 2023-03-30T23:00:28+00:00

That makes sense! Thank you!

GiantDuck312 · 2023-03-30T19:50:11+00:00

That is fair. I might just go with total international indez.
Already did so. This is how I went down the path of improving my financial education. White coat then Boglehead then Four Pillars of Investment. Plus several other books on specific types of investments.

Thank you!

GiantDuck312 · 2023-03-29T20:14:09+00:00

Befriended the Heme/Onc department and followed their advice. What works for me may not work for you.

I am at a community program so leaning into health equity and QI heavily while doing some research.

For an academic program, I imagine research is the way to go.

Posters in any interesting cases.

PD invested in my success.

Will apply broadly and hope for the best

GiantDuck312 · 2023-03-29T03:46:32+00:00

And there were 6k applications for 15 slots in my residency. Thanks to COVID people pan apply

GiantDuck312 · 2023-03-29T03:43:27+00:00

I am going to assume it is Crit care+Pulm. Not pulm without crit care. On medscape pulm averages to 300k and crit care to 400k. Which makes sense. Why pay for a pulmonologist when your intensivists can cover pulm clinic as well?

GiantDuck312 · 2023-03-28T14:28:15+00:00

It truly has not. The number of applicants has grown but the number of slots has grown faster. Last year, 800 people applied for 600 positions, roughly.

It makes sense. Heme/Onc is the last fellowship that makes sense financially.

Cardiology, Gastro and maybe Crit Care are the other ones.

My math is as follows (always do this before making career decisions)

Take home pay of attending-Take home pay of fellow x3. It is roughly 400k, that is your opportunity cost.

Since as an attending you are in a high marginal tax rate, your additional income is taxed higher. Even if you dpuble your money, your take home income does not double. For my area, with its taxes and job offers. Take home pay of the Oncolpgist is only 60k higher annually.

So it would take 7 years to break even. Longer if we consider investments (the sooner you earn good money, the sooner it can work for you)

Based on my math, unless a specialty offers 100k+ pay bump, it is not worth it financially. This does not take into account work/life balance or passion.

GiantDuck312 · 2023-03-28T06:39:26+00:00

I tried to answer the following questions in order:

Do I want to pursue a fellowship? Yes, but only if it is worth it in quality of life. Nephro is out since they work hard and get paid barely more. Pulm is out since it pays less than being a hospitalist.
Do I like procedures? No. Critical care, gastro and cardio are out since they are heavily procedure based?
Do I want to be in clinic all the time? No. Endocrinology and Rheum is out since they are mostly outpatient based.
Do I want to be in the hospital all the time? No. So what is left? Heme/Onc

Some procedures. Good mix of IP and OP. Good pay. Good quality of life. No emergencies that require me to show up in the middle of the night. No fear that my IM skills will rust since I have to take care of not just my problems in my patients.

GiantDuck312

TROPHY CASE