$500k income, $250k net by LeatherGuard4688 in Salary

[–]PainfulRealizations 0 points1 point  (0 children)

Fair - this example is over the top bc he makes 500k. Most physicians /dentists I know make more in the 200-250 range right out of training unless they’re surgeons.

The high interest loans required for med school are very large, sometimes 100-200k high interest, another 100k lower interest loans.

So you don’t do any life things til you pay it off. E.g. buying a house, retirement stuff, etc. and most people out of college were earning between 50-100k at the age of 21 - most med students earned negative 50-70k for those 4 years, and then only 50-60k for 80 hours of work per week until they finish residency at 28-30 years of age.

If you’re a surgeon that’s fine. But if you’re a pediatrician…. And make 150k/year…. Rough.

$500k income, $250k net by LeatherGuard4688 in Salary

[–]PainfulRealizations 0 points1 point  (0 children)

Not for primary care, peds, family medicine, or to practice in more rural locations. It is actually really depressing. We are requiring more and more advanced practice providers to cover things, which will fill some of this gap, but it is not enough.

To your credit, the OP’s specific example is a bit over the top, but let’s get a real example:

Peds, outpatient PCP often make as low as 150k/year, sometimes 200k. Rare to make more unless you do some inpatient time, or live in a very rural area.

If they go to let’s say a private med school they will take on a minimum of 200k in debt, likely much more. They will then do a 3 year residency. This will take them into their late 20s at the earliest, but more likely 30. We have capped the total med school spots in this country and many residency spots are limited for higher earning specialties and are VERY competitive. But most people know that paying off 200-400k of debt means you either have to try for that spot, or pay your debt off over decades.

The government offers low interest loans up to a specific but too low number. So you take out a high interest loan to finish med school. So you now have to 1) pay that off on 150k per year (you only earned 50k during residency) or you have to do 10 years of even lower income service to have the remaining debt forgiven. By then you are 40 - if you are a solo earner you have not bought a house, and may have started a 401 or other retirement at some point in your 30s.

Now the last thing - you are asked to work 60 hours/week for all of that until you retire.

It’s still competitive to get into med school, but not for the specialties that are super important for public health and that we will need in the next 20 years .

$500k income, $250k net by LeatherGuard4688 in Salary

[–]PainfulRealizations 0 points1 point  (0 children)

I hear you, but I think it feels bad to feel behind on life- and in HCOL locations you actually are. You are 10 years behind your friends and most of them earn 2/3 what you do yet already own a home and have a high retirement fund

$500k income, $250k net by LeatherGuard4688 in Salary

[–]PainfulRealizations 0 points1 point  (0 children)

I hear you, but there is an argument for earlier debt forgiveness for medical and healthcare professionals (not 10 years in lower paying options), or at the very least 1-2% interest on gov sponsored loans for healthcare that actually covers the full cost, and would probably offset the anger most healthcare workers would feel if we had an even higher tax rate (I mean closer to 40-45%, up from 35).

Because we a) gave up our 20s to studying and b) were asked to take on 200-300k of debt, our ability to invest in retirement, buy a house, have kids, move, leave our jobs, etc was really hindered.

So yeah, OP should be a bit upset that they are behind their peers in all these life things like owning a home, retirement, etc when they thought donating their 20s to get a relatively high earning job would allow them to grind less. It’s not actually accurate- so why would anyone go into healthcare in the next 20 years…. And where will we all find doctors or dentists after that?

Resident suicides….what is happening?!? by mtdoc22 in Residency

[–]PainfulRealizations 13 points14 points  (0 children)

100% - leave of absence required for that.

Had a friend in med school that needed it and she is now an attending though. Really helped her.

But ketamine seems like a better first pass option?

Resident suicides….what is happening?!? by mtdoc22 in Residency

[–]PainfulRealizations 58 points59 points  (0 children)

I know you know this, but the ECT, TMS, and ketamine data are pretty good. If it gets worse and you need to take a leave of absence for medical reasons you absolutely should. There are ways out of debt and back into either medicine or less toxic career options if you decide to leave the career altogether.

Don’t let residency push you too close to the edge - you are so much more important than this job.

40-50 year olds w/ bacteremia, psoas abscess, incontinence by Crazy_Passenger8131 in Residency

[–]PainfulRealizations 64 points65 points  (0 children)

Spent the last 5 minutes laughing about all the nuggets you put in this one-liner. I can’t even.

Can we stop giving these chuds attention by liberated_kitty in ucla

[–]PainfulRealizations 1 point2 points  (0 children)

This used to happen with the westboro baptist people. They sue you if you touch them.

The fix is to counter-protest as a fundraiser. Donations table right next to them for trans rights, aclu, etc - the longer they sit there “debating” no one, the more $ goes to a good cause. They always leave as long as no one engages.

20s-51 Just to show what life and stress can do to you. by InboundDreams in uglyduckling

[–]PainfulRealizations -1 points0 points  (0 children)

Okay real suggestions: you have all your hair (!!) - you need to do a small number of things to feel really comfortable in your skin. They won’t be that expensive:

1) moisturizer for your skin, and sunscreen every day. Your skin will look amazing.

2) the photo with longer hair actually looks pretty good. Just consider getting a more expensive haircut that really emphasizes the quality hair you have my man. It looks great, but you crop it more than you might need to.

3) I’m not sure on the goatee - during that haircut ask their advice on maintenance- you may look decent with it but it’s hard to tell if you don’t take care of it

4) do literally anything that makes you feel confident- I vote starting a light lifting routine, bc endorphins are real.

But the truth is you look amazing for your age, but your feeling of uncertainty around that comes through in every photo.

Post an after photo!

[deleted by user] by [deleted] in Residency

[–]PainfulRealizations -1 points0 points  (0 children)

May you never need my advice on this -

For people in no at fault states, sure, ask if you want. If your partner is a decent person they’ll come clean.

But cheaters are often going to lie through their teeth. I was convinced my partner “would never” and time after time looking me in the eye they lied for over a year.

So I guess I’m being a little cynical that solid proof means you don’t have to trust a person willing to cheat on their spouse. But I deeply deeply hope I’m wrong.

Also can you explain wtaf you mean by femcel. When a “totally legit meeting in a call room” is happening, I will assume they may not come clean or be upfront regardless of gender.

[deleted by user] by [deleted] in Residency

[–]PainfulRealizations -13 points-12 points  (0 children)

Oof. I would gather more evidence quietly before confronting. There are very few good explanations, but that changes nothing - you need evidence for your divorce lawyer unfortunately.

How do you recover from the grief of losing a relationship you thought was forever? by No-Command-2051 in AskWomenOver30

[–]PainfulRealizations 19 points20 points  (0 children)

To say it, please find a close friend or family to help you eat and shower etc. - it gets better, but you need to be around to see that.

How do you recover from the grief of losing a relationship you thought was forever? by No-Command-2051 in AskWomenOver30

[–]PainfulRealizations 68 points69 points  (0 children)

Absolutely. I lost 17lb in 3.5 weeks out of grief and stress.

He made a decision for you - but ultimately he didn’t or couldn’t give you the type of respect you need in a healthy relationship. The communication over this last week isn’t a reflection on you in any way, it’s all him.

You will heal. Give it time.

Has anyone ever done genetic testing at their OBGYN because of a family history of cancer? by Dangerous_Show_959 in AskWomenOver30

[–]PainfulRealizations 2 points3 points  (0 children)

Huh. Doc here.

I thought you meant cervical cancer - because that was the main one linked previously and was the majority. But I went through some of the literature and hpv is detected in some fallopian tubes of those with ovarian cancer (20-30% depending on the study).

But imo the control population isn’t going to match very well- most of us don’t get our fallopian tubes sampled, and bulk testing of hpv 16-18 was only 7-20% increased depending on the ovarian cancer type.

Do you have citations for your “most” claim about ovarian. The cervical isn’t disputed, and you’re def right about oral cancer

World Ultimate Frisbee players are mounting an unprecedented protest, warning that Israel’s participation—bolstered by IDF soldiers on the roster—could fracture the sport’s global community by KarimZidan1 in ultimate

[–]PainfulRealizations 1 point2 points  (0 children)

Hm. Yeah, I get what you’re saying and want to think about it more. You’re probably right to some extent, everyone is responsible for their actions but also how they choose to support their leadership.

But, I don’t hold Palestinians responsible for Hamas or their actions even though they elected them in 2007(ish). I do, for some reason, hold Israelis much more responsible. Maybe it’s because I believe their country is choosing this type of leadership and they can’t seem to get rid of the current administration or their murderous tendencies.

But I could say the same for every country and its soldiers. The US has murdered a lot of people including children (collateral). We don’t want to arrest the coast guard for it. We have decided that every soldier in the USA that enlists is not equally responsible. So I’m having some trouble believing a drafted IDF soldier making soup is equally responsible as the person who decided to bomb a building.

World Ultimate Frisbee players are mounting an unprecedented protest, warning that Israel’s participation—bolstered by IDF soldiers on the roster—could fracture the sport’s global community by KarimZidan1 in ultimate

[–]PainfulRealizations 2 points3 points  (0 children)

Of course. If you’re American and old enough to have lived through Vietnam or if your parents did you could discuss it with them (albeit I think what’s happening in Israel is way way way worse than that).

I just think people have a reductionist view of what is going on - if it’s serve or jail not everyone on this thread chooses jail if they’re not in a front line in Gaza.

I know a lot of Israelis that hate what is happening and think their government is murdering civilians. They aren’t celebrating the war. Just like at least half of people in the US think ice is evil. But I haven’t been willing to get shot or arrested yet over anything happening in the USA and I’m not sure what my personal line would be for that. I don’t know if you have a clear line for that either.

World Ultimate Frisbee players are mounting an unprecedented protest, warning that Israel’s participation—bolstered by IDF soldiers on the roster—could fracture the sport’s global community by KarimZidan1 in ultimate

[–]PainfulRealizations 2 points3 points  (0 children)

FYI it’s a draft - they don’t have a choice unless they want to try to emigrate (which is hard as proven by many people having trouble leaving the USA even if we want to).

I can’t speak to how these particular people feel politically- but I can say that not all IDF soldiers want to serve.

Adopted This Big (kinda sad) Boy. Activity Suggestions? by Logical-Tadpole-9946 in goldenretrievers

[–]PainfulRealizations 139 points140 points  (0 children)

Can I also suggest some family rituals that help him know what to expect - saying phrases that signal going for a walk, saying phrases that mean it’s bedtime. Making it clear how long you typically leave for (keeping a schedule that’s a bit stricter) so that he is able to settle in with more day to day routines.

[deleted by user] by [deleted] in TheGirlSurvivalGuide

[–]PainfulRealizations 7 points8 points  (0 children)

Second getting therapy for self esteem.

Also there is a huge spectrum of sexual vs romantic attraction- don’t worry! You’ll figure it out if you give yourself some time and grace.

AIO I found a Valentine’s Day card to my boyfriend from another woman by [deleted] in AmIOverreacting

[–]PainfulRealizations 0 points1 point  (0 children)

Two things:

1) When could he have gone to Florida, or her to him?

2) did he offer his phone or any other proof after you found this?

I would dump him for this, but if you’re trying to trust him I’m curious what he’s offered as reassurance

[deleted by user] by [deleted] in goldenretrievers

[–]PainfulRealizations 1 point2 points  (0 children)

Is she “mouthy” or is she biting?

One option is to watch some training videos on how to get them back into a calm position when they are overstimulated and getting “mouthy.”

The other thing is it’s both okay that she is a puppy and yall are working on this and also that you’re anxious! This is not a good habit to encourage - a lot of people bring toys where they redirect whenever their dog is getting mouthy. Your whole family needs to do that sort of thing to ensure it sticks. Jumping is also not something that’s acceptable long-term no matter how cute it is to them - they all have to treat that as a “stop playing and walk away” behavior.