Most long-running blogs I read have a “sorry its been so long since my last post”, post. If this is a generally-normal reality of long-running blogs, then maybe SW101 can officially call itself that.
I haven’t been writing for about 1000 reasons, but I think the most draining of them has been the job search. Finding a job as a doctor is tough. Let me be clear: not tough like it must be for a house-framer with 2 kids and an upside-down mortgage. But tough to make sure I’m not making a mistake.
Medicine is so owned. There are just so many stakeholders in the entire enterprise that being a doctor today is a bit akin to indentured servanthood. In some respects, this is great. Better to be someone’s servant than nobody’s king. But in my world, it IS rather easy to make an un-critical choice and end up even more owned than you need to be.
I owe TONS of money to lenders who “helped” (in the way pedophiles “help” little kids with their math) me get through an over-priced undergraduate experience and then medical school. Yes, I’m bitter about the experience because debt rules my life and will continue to until I am well beyond my youth. All of my best years will have been spent paying off debts before I’m finished.
For that reason, choosing a job is edgy business. Family docs are in demand, even in today’s economy. So, many of the places I’ve applied are offering numerous incentives like sign-on bonuses and loan-repayment. They both sound great, right? Just sign up for whoever is offering the best deal, right?
Well, let’s start with the “sign-on bonus”. Every place I’ve spoken with offered one of these…but it would need to be “forgiven” by working with them for 3 years. Immediately, it should be clear that this, then, isn’t a signing bonus, its a retainer, which is much different. Granted, true signing bonuses are a rather dimwitted business maneuver, but I hate the disingenuousness of calling it one thing that implies no repayment, but really meaning something that in fact does require repayment.
Then the loan reapayment. I’ve been offered as high as $45,000! Amazing, isn’t it? In addition to my above-average salary, I’m being offered the average salary of a luckily-employed American to help pay off loans. Of course, like the “bonus”, it has to be paid back too. Over years. So, both benefits amount to more effective debt for me. I will owe time rather than money, but I still OWE someone. Since I owe them…they pretty much own me. Given all the people who already have their teeth in my ass, I’m surprised yet another entity thinks they have can gnaw a chunk out of my back side, but apparently they want to try.
I should mention that both grants are taxed, which changes everything also. Take the loan repayment. 45k? Nice. How much will I see? About 30-35. Still a lot of money, yes. But let’s not forget how much I owe: $320,000, compounding at an average rate of about 8%. That 33k will barely pay off interest on all that I owe…and I’ll still owe the person who gave me the money 3 years of my life. It’s debt on top of debt.
So, I’m close to signing with a local HMO that is offering some loan repayment, but is letting me work for it, which means they’ll come up with some cash at the end of 3 years. Yes, I’ll lose on the front-end given the cost of interest…but I’ll keep my freedom. Well, that’s certainly a matter of perspective, but I’ll keep something.
My apparent need to keep some semblance of control over my life reminds me of the movie Dead Man Walking. At the end of the movie, as Sean Penn is about to be led from his cell to the execution chamber, he freaks out and puts up a huge fight because the guards want to take his boots. True, your boy ain’t going somewhere that will ever require boots. But that’s not the point. They represented his only real hold on control over his life by the end. I feel a little bit that way. Sure, I’m losing by not getting any up-front money, and sure, I can’t leave any job EVER until I’m retired because of all my other debts. But at least, coming out of residency, I’m not adding yet another person who owns my life. At least I’m still as much my own man as I was before I signed on to a new job. Freedom, even a wisp of it, is worth the sacrifice.
Next up: The job itself and how it won out over the others.
6 thoughts on “About To Drink The Kool-Aid”
Glad you posted your experience and insights!
I am tweeting blog link and selected take…you speak for many, IMJ.
Health reform is critical for the reasons you cite as well as many others.
In the words or another, “impossible” but “necessary”.
So you are staying in your local town?
Yes, most likely. More on that in the next few days.
It always seemed that Kristofferson had it wrong! Good luck with what sounds like a well-reasoned choice.
Guys A useful medical jobs page in Australia can be found at http://fastmed.org
This is an excellent medical executive position in a highly regarded regional hospital in Australia.They can supply medical recruitment at all levels-and most disciplines. Whether you need cover for short or longer term needs, or to fill a permanent position, They can help.
The Postgraduate Medical Deanery also has contacts in Australia which you may find useful. See their website http://fastmed.org
Just try it see how useful for our job career.