Making $1M is pretty much unheard of unless you’re a neurosurgeon working insane hours. Your friend is definitely an anomaly. Paradoxically you get paid less in more desirable urban areas with higher COLs as a physician. So it’s true that if you’re fine with living in an area that has a physician shortage you can make really good money in a low COL area. I find a lot of meaning in my work and overall don’t regret my decision but these days if you’re going into medicine for the money, you’re gonna have a bad time.