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Comment by bradleyjg | Hacker News Reader

I have a hypothesis that at least in the US smart people that want to continue with the same sort of “do the work you are assigned and be rewarded” become doctors. There are entrepreneurial paths in medicine but an excellent student that wants to can go from medical school to a residency, followship, and then a hospital position and earn enough to be in the 1% without ever needing to fight for it in the office politics / networking / job hopping sense. There are few or no other professions where that’s true, certainly not any that are so large in terms of numbers.

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As someone who is very close to two doctors, I can tell you that networking and elbows matters just about as much as any other career.

Second this, you need to be political to make partner in your practice or move up the ladder to manager/professor even as a Dr. unless you go into private practice or start your own thing

Absolutely. A couple that my wife and I are dear friends with are both in the medical profession. Nuclear medicine and pediatrics. They spent the first 8 years of their careers in NYC, establishing themselves / their careers. He's now in SoCal and she's in NorCal. They have 2 kids. They anticipate that they'll be split up for a couple of years in this manner because of their work situations. He's flying back and forth to be with his family. He's tried to get positions near their new home but he's either over-qualified or he's not getting bites.

They have to play networking and social games with their careers to a level that is well and truly beyond anything my wife and I have ever had to deal with as software engineers.

My wife and I have board game nights and that qualifies as networking. We're playing board games with folks from FAANG companies, triple A video game developers, interesting start-ups, etc... who I've met through this group. Our friends in the medical profession can't get away with something like that.

A number of my friends are recent med school graduates, and from what they tell me that politics is very much a factor not just for advancement, but even things like placement in a medical specialty.

"Become doctors" is just saying that they graduated medical school; even C students become doctors, but the politicking really starts once you try to join a specific practice, like cardiology, emergency medicine, pediatrics, etc. Every speciality has its gatekeepers who they need to schmooze if they want that seal of approval.

It’s true that they need to get residencies and then fellowships but my understanding is that these processes are closer to “get admitted to medical school” then they are to “become partner at a law firm”. Could be wrong, but that’s my impression.

The majority of US doctors have huge student loan debts for many years, they either must go into a specialty to pay them off quickly, or remain middle-class for years as primary care, pediatrics, geriatrics, and many other needed specialties are under-remunerated.

This is a popular story, but really they stop taking on debt at about 30 and pay it off, easily, by 45.

Around here you can live a nice lifestyle for ~$40,000. Early career primary care physicians have a gross of something like $120,000...

That path will barely get you to 1% income, and definitely not in all areas. Just another working stiff.

The Dr. who runs the LASIK place near me drives a Lambo, and he probably has 10 Drs working for him.

It’s rare to strike it rich on your own labor.

My heart bleeds for “barely 1% working stiff”.

That sounds like a serious medical condition, you should contact your doctor.

Preferably one with a Lambo.

He might not earn an obscene amount of money: there was an article here recently about spending habits, and doctors seemed to be the worst.

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