Dear Dr. Goodhook,

I have $160,000 in school loans that I have to pay back soon after I complete Residency in June.

Recently, I started searching for opportunities in downtown Chicago. I couldn’t believe that the Physician compensation (i.e. starting salaries) are $75,000 less than what most of my colleagues were offered in non-metropolitan areas.

As I began shopping for houses, I am shocked that the price of a modest 3,000 square ft house started off at $625,000.

I am conflicted between whether I should practice in Chicago or look 90 minutes outside Chicago where Physician compensation is much higher and cost of living is much lower. How do I make the right decision?

Signed,

Concerned General Surgeon

Dear Concerned,

As the venerable Hippocrates once stated, “Prayer indeed is good, but while calling on the Gods a man should himself lend a hand.” In this instance, I verily believe that you have a moral obligation to choose a wise path, in order to fully resolve this potentially obstructive and debilitating dilemma. As with the four humors, it appears that you are balancing various factors, which need to be weighed with the exacting precision of the talented physician.

Life is perilous for the thoughtless, and strewn with obstacles. However, none of these obstacles are so large in stature that they cannot be overcome.

It is your duty to achieve a position of pecuniary stability, in order to devote your full mind to the noble art of apothecary. To this end, you must consider carefully the hierarchy of needs which each human incurs.

What life is this, if we do not have the stability to live within it, fulfilled?

Thus, consider issues such as commuting time, the number of medical establishments to which you will gain access through your choice of abode, and indeed the fiscal rewards of the positions you will potentially be granted.

Our venerable vocation is arduous enough, without struggling against the choppy tides of financial misfortune. Select your home with the utmost care, as a welcoming abode is indeed the castle from which fruitful endeavors and the pursuit of a rewarding career ensue.

What say your fellow medical colleagues, in relation to the area within which they abide?

Seek counsel from those with more experience, and listen wisely to the fulsome words which pour forth, enabling you to reach a truly enlightened decision. In matters of the mind, assistance can be sought through listening closely to the instinctive response of our souls, when we turn inwardly and ascertain our true reaction to certain enquiries.

Where, then, would you choose to reside? Should you weigh up the advantages of each scenario, which imagined outcome swells your heart with positivity and enthusiasm?

Might I refer you to the work of a learned colleague of mine, whom in his wisdom developed the analytic hierarchy process? With a little careful consideration, the balance which you seek from your situation will soon become as clear as the transparent pools of life in which we swim.

– Dr. Goodhook