Do doctors that have rotations at their offices get paid?

[TheSeanieB]

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[IMDoc607]

I have heard that doctors who open there office do not get paid for allowing a student to rotate. Is this true? If so, what is their motivation (beside a desire to teach) when allowing students to rotate thru?

To teach....why do you need money? Some docs just enjoy teaching.

 

[mimelim]

I have heard that doctors who open there office do not get paid for allowing a student to rotate. Is this true? If so, what is their motivation (beside a desire to teach) when allowing students to rotate thru?

Life is way too short to need to get paid for everything that you do. I work 80 hours a week as a resident (hah, who am I kidding, if you include research, administrative etc, I'm in the hospital ~100 hours a week). I'm still going to make the time to teach our interns how to do central lines or suture, because that is what I enjoy doing.

 

[blaqmamba]

Some can receive CME credits, I believe (don't quote me on this). Also, most get some sort of department award to hang up in the office

Having incompetent third years mess up the flow of your clinic for sure. On the other hand though, you can use third years as nurses to do vitals and patient intake and save yourself about 15$/hr per nurse! Imagine the guy who has 3 med students working with him...

 

[THP]

I'm taking a 3rd year student in my office this year and I do get a stipend. Its not a ton of money but it doesn't hurt. Also I get some sort of adjunct faculty position from the medical school. And I got a hat, t-shirt, and one of those plastic cups with a straw.

 

[mvenus929]

My family medicine preceptor gets a stipend for each student he has rotate with him. He flat out told me that he's using the stipends he gets to fund his family's vacation to the World Cup in a couple years.

 

[tiedyeddog]

I am doing a rural FM rotation. He is not getting paid and is in private practice. The guy is just awesome and likes teaching.

 

[secants]

The outpatient offices I've been to usually do it primarily because they like teaching. Others also get some minor title from the school and/or some recognition from their specialty association. I'm guessing the ones that get a stipend is mostly because the school was desperate for sites.

 

[Shinken]

I have heard that doctors who open there office do not get paid for allowing a student to rotate. Is this true? If so, what is their motivation (beside a desire to teach) when allowing students to rotate thru?

1- I enjoy teaching and it keeps my knowledge current.

2- I get CME credit for having students rotate through my office.

3- My staff enjoys having students, particularly when they're enthusiastic (my nurse enjoys teaching students how to do a rapid strep test, etc.)

 

[blaqmamba]

1- I enjoy teaching and it keeps my knowledge current.

2- I get CME credit for having students rotate through my office.

3- My staff enjoys having students, particularly when they're enthusiastic (my nurse enjoys teaching students how to do a rapid strep test, etc.)

Thanks for clearing it up about the CME credits. Do you feel that you can use the students instead of hiring a nurse (or two)? And wouldn't that essentially be a 'stipend'

 

[VA Hopeful Dr]

Thanks for clearing it up about the CME credits. Do you feel that you can use the students instead of hiring a nurse (or two)? And wouldn't that essentially be a 'stipend'

In a busy office, it wouldn't be worth it. Your nurse knows how to do everything quickly, the way you want it, and often without being told. It takes some time to train that, and most students won't be around long enough.

 

[Winged Scapula]

In a busy office, it wouldn't be worth it. Your nurse knows how to do everything quickly, the way you want it, and often without being told. It takes some time to train that, and most students won't be around long enough.

Agreed.

Besides, you are rotating at my office to learn the duties of a physician/surgeon, not a nurse. There is no sense in training you to do something that doesn't fit your job description.

I am offered a monthly stipend for students who rotate with me; its pretty small (especially considering I have to slow down the practice when I have students) so I've never taken it.
CME units are given too but they are Category II, not sure what I do with those.

 

[CDI]

Huge market for IMGs to snag an LOR, if the doctor has privileges and can take then to a hospital even better. Usually allows the doctor to pocket $1000-1500 cash/month.

 

[Winged Scapula]

Huge market for IMGs to snag an LOR, if the doctor has privileges and can take then to a hospital even better. Usually allows the doctor to pocket $1000-1500 cash/month.

What are you suggesting?

That PP physicians charge IMGs $1000-$1500/month to rotate with them?

 

[CDI]

What are you suggesting?

That PP physicians charge IMGs $1000-$1500/month to rotate with them?

No, I already know it happens. My cousin rotated with one. The guy pulls in $15k a month off of rotating IMGs.

Most programs in the US have this ridiculous requirement where they require USCE (US clinical experience) to consider IMGs for residency. Yet when an IMG asks them if they offer any such opportunities the PDs and/or coordinators look at them like they're speaking a foreign language.

Hence the win-win market created by entrepreneurial private practice docs whom also have privileges.

Its like how every "entry-level" job in the US somehow requires 2-3 years of experience. System is screwed from the top down.

 

[Winged Scapula]

No, I already know it happens. My cousin rotated with one. The guy pulls in $15k a month off of rotating IMGs.

Seems distastefully opportunistic to me (on the part of the PP physician).

 

[CDI]

Seems distastefully opportunistic to me (on the part of the PP physician).

It can be, if the student learns very little, but its far better than doctors who don't help at all.

It's just another method for established physicians to collect "dues" from those younger, while still offering some benefit to them as well.

 

[VA Hopeful Dr]

Seems distastefully opportunistic to me (on the part of the PP physician).

The local DO school here pays ~1k/student/month as well.

 

[primadonna22274]

My DO school (LECOM) does not pay for rotations, and we're losing valuable slots (think UPMC) to those schools that do pay. Didn't affect me directly as most of my rotations are in the southeast (had to set them up myself) but I'm finding it difficult to find good rotations now that VCOM-Carolinas students are rotating (they do pay, don't know how much). I only need one more but I predict it will be more difficult for future students from my school to compete as precepting physicians get used to being paid to teach.
I used to find it distasteful but I admit we do slow the docs down. It's a tough balance.

 

[GlowInTheDark]

My DO school (LECOM) does not pay for rotations, and we're losing valuable slots (think UPMC) to those schools that do pay. Didn't affect me directly as most of my rotations are in the southeast (had to set them up myself) but I'm finding it difficult to find good rotations now that VCOM-Carolinas students are rotating (they do pay, don't know how much). I only need one more but I predict it will be more difficult for future students from my school to compete as precepting physicians get used to being paid to teach.
I used to find it distasteful but I admit we do slow the docs down. It's a tough balance.

As an aside, I have heard it wasn't the lack of paying for student rotations, but the turf war between UPMC and Highmark and LECOM hooked up with Highmark.

 

[VA Hopeful Dr]

My DO school (LECOM) does not pay for rotations, and we're losing valuable slots (think UPMC) to those schools that do pay. Didn't affect me directly as most of my rotations are in the southeast (had to set them up myself) but I'm finding it difficult to find good rotations now that VCOM-Carolinas students are rotating (they do pay, don't know how much). I only need one more but I predict it will be more difficult for future students from my school to compete as precepting physicians get used to being paid to teach.
I used to find it distasteful but I admit we do slow the docs down. It's a tough balance.

Yeah, your last point is a valid one.

My partner and I both like the idea of teaching and woudl gladly do it for free. But, if some school wants to pay me for it I am OK with that too.

 

[primadonna22274]

Yeah, your last point is a valid one.

My partner and I both like the idea of teaching and woudl gladly do it for free. But, if some school wants to pay me for it I am OK with that too.

Agreed. I will always teach. It would be a plus to be paid a bit for the pleasure though.

 

[evilbooyaa]

As an aside, I have heard it wasn't the lack of paying for student rotations, but the turf war between UPMC and Highmark and LECOM hooked up with Highmark.

As someone in the area, this is likely one of the biggest factors to the split between UPMC and LECOM.

 

[KnuxNole]

No, I already know it happens. My cousin rotated with one. The guy pulls in $15k a month off of rotating IMGs.

Most programs in the US have this ridiculous requirement where they require USCE (US clinical experience) to consider IMGs for residency. Yet when an IMG asks them if they offer any such opportunities the PDs and/or coordinators look at them like they're speaking a foreign language.

Hence the win-win market created by entrepreneurial private practice docs whom also have privileges.

Its like how every "entry-level" job in the US somehow requires 2-3 years of experience. System is screwed from the top down.

I don't think it's ridiculous at all to require US clinical experience as a foreign grad applying for a US residency. I do agree that if a foreign graduate(who isn't from the US) wants to gain experience, that there should be opportunities. As far as I'm aware, there are externships/observerships which people do. I have no idea what they entail, but ideally, if a foreign grad wants clinical experience, they can find it with diligent searching.

 

[CDI]

I don't think it's ridiculous at all to require US clinical experience as a foreign grad applying for a US residency. I do agree that if a foreign graduate(who isn't from the US) wants to gain experience, that there should be opportunities. As far as I'm aware, there are externships/observerships which people do. I have no idea what they entail, but ideally, if a foreign grad wants clinical experience, they can find it with diligent searching.

I think its absolutely ridiculous when programs write it as a residency app requirement, yet offer nothing at their own location.

Its a PC way to say, "We discriminate against IMGs, but not outwardly...so here's a hint." What are they afraid of?

If they don't want to take IMGs so be it, just say you only accept AMGs and be done with it.

 

[Houmd]

Just to add to the conversation.

Getting US rotations as an IMG is very difficult. There just aren't enough people willing to offer rotations to us and b/c of that most of the places/attendings that will accept a student require money to do so. I know this is especially prominent in Chicago & NYC. Many Primary care offices (seen this several times among other students) will make an agreement with a school to take 1-3 students but then turn around and make the same deal with multiple schools and take upwards of 10 students in a clinic and run them like employees. It's ridiculous, but for some people that's the only experience they can get.

Just like CDI mentioned most residency programs want 6mos, 1yr or 2yr USCE (US clinical experience) but flat out refuse to allow IMGs to rotate through any of their programs. Very hypocritical in my opinion.

Either way, yes a lot of PCPs take money for medical students esp in the chicago area. To my understanding typical rate is $100-150/week/student and so good ones will take 1-2 students but some who do it just to take advantage of the system and make money will take way more than that.

There's actually an urgent care clinic in downtown chicago that takes several students and makes them work as secretaries/nurses in addition to being medical students

 

[KnuxNole]

Just to add to the conversation.

Getting US rotations as an IMG is very difficult. There just aren't enough people willing to offer rotations to us and b/c of that most of the places/attendings that will accept a student require money to do so. I know this is especially prominent in Chicago & NYC. Many Primary care offices (seen this several times among other students) will make an agreement with a school to take 1-3 students but then turn around and make the same deal with multiple schools and take upwards of 10 students in a clinic and run them like employees. It's ridiculous, but for some people that's the only experience they can get.

Just like CDI mentioned most residency programs want 6mos, 1yr or 2yr USCE (US clinical experience) but flat out refuse to allow IMGs to rotate through any of their programs. Very hypocritical in my opinion.

Either way, yes a lot of PCPs take money for medical students esp in the chicago area. To my understanding typical rate is $100-150/week/student and so good ones will take 1-2 students but some who do it just to take advantage of the system and make money will take way more than that.

There's actually an urgent care clinic in downtown chicago that takes several students and makes them work as secretaries/nurses in addition to being medical students

TEN students in one clinic? How do they have room to fit them all? I'm assuming it must be a place with multiple physicians. Still, oversaturation of rotations is a very negative thing. I remember a med student on the interview trail talking about how for her OB/GYN rotation, there were so many students it was chaos. 6 or more people in L+D. :O

 

[blaqmamba]

That's why I said that attendings can, and do, treat med students in such a way that even if they weren't getting paid directly, it was essentially saving a ton of money

 

[Cranial ALLDAY]

my doc gets a stipend

there was an article in the NYT few years ago about one of those weird carribean schools paying a few mil for 3rd yr spots in nyc

 

[JediZero]

my doc gets a stipend

there was an article in the NYT few years ago about one of those weird carribean schools paying a few mil for 3rd yr spots in nyc

Yeah, I remember that. St. George's, wasn't it? And then Touro-NY blamed their inability to secure enough clinical rotations for their third years on that?

In any case, I don't know what it's like on the MD side (though it's presumably less of an issue with attached hospitals/health care systems), but paying rotation sites and individual preceptors on a per-student basis appears to be the norm for osteopathic schools. That's mostly hearsay, but I know mine certainly does.

As for 'replacing nurses/MA's' with medical students, that's just not practical. The work that we do certainly doesn't make up for the time it takes to teach us what to do (especially over a four-week period). Doing an H&P and presenting it takes us three times longer than it does for them, and then they have to re-do the whole thing themselves anyway (though I have heard of some extremely busy clinics where the med students are basically being PA's, doing everything themselves and signing out to the attending).

Attendings have a saying (which might be a House of God quote: "Show me a medical student who does not triple my work, and I will kiss the ground at her feet."

 

[Siggy]

As for 'replacing nurses/MA's' with medical students, that's just not practical. The work that we do certainly doesn't make up for the time it takes to teach us what to do (especially over a four-week period). Doing an H&P and presenting it takes us three times longer than it does for them, and then they have to re-do the whole thing themselves anyway (though I have heard of some extremely busy clinics where the med students are basically being PA's, doing everything themselves and signing out to the attending).

That was how my OB/Gyn rotation was (go see patient, follow algorithm for the non-complaicated stuff (like when to do GBS cultures, etc), if I need to do a pelvic or wet mount, do it before presenting, present patient, give patient prescriptions), and to a much lesser extend my EM rotation (go see relatively stable patients, do H&P, present to EM resident (or to off service intern or attending if the resident is busy with another patient), drop off t-sheet at the secretary for initial lab orders, inform nurse of initial medication orders). Of course the big difference between the two rotations is that the EM rotation is a 4th year rotation and an audition rotation.

Attendings have a saying (which might be a House of God quote: "Show me a medical student who does not triple my work, and I will kiss the ground at her feet."

One of the laws of the House of God. I almost got to violate the radiology one the other day.

 

[JediZero]

I don't know if you're NWT or not, but Peds in Chehalis (Tacoma) is like that, from what I've heard. Would have been nice to get some more experiences like that before now, but I guess I just have to learn quickly, haha.

Yeah, I really need to get around to reading that, haha. What's the radiology one?

 

[Houmd]

#12 "if the radiology resident and the medical student both see a lesion on the chest x-ray, there can be no lesion there."

 

[prometheus09]

I have heard that doctors who open there office do not get paid for allowing a student to rotate. Is this true? If so, what is their motivation (beside a desire to teach) when allowing students to rotate thru?

I think that they get the option to either get paid or get CME credits, because I remember one of my attendings complaining that he needed to fill out some paperwork to get CME credit for hosting med students.

 

[Siggy]

I don't know if you're NWT or not, but Peds in Chehalis (Tacoma) is like that, from what I've heard. Would have been nice to get some more experiences like that before now, but I guess I just have to learn quickly, haha.

Nope.. So Cal. Personally, I enjoyed the rotations where the students got thrown in over our heads because it forces you to pick up a lot in a short amount of time. There's too many So Cal rotations with weak standards, low volume, low pathology, but I managed to avoid most of those places.

Yeah, I really need to get around to reading that, haha. What's the radiology one?

It got quoted above. Caught a lung bullae on CXR the other day that's been growing over a decade without comment.

 

[JediZero]

Nope.. So Cal. Personally, I enjoyed the rotations where the students got thrown in over our heads because it forces you to pick up a lot in a short amount of time. There's too many So Cal rotations with weak standards, low volume, low pathology, but I managed to avoid most of those places.



It got quoted above. Caught a lung bullae on CXR the other day that's been growing over a decade without comment.

Yeah, I hear you. Can't speak to the entire NWT, but at least in my neck of the woods, they have trouble recruiting preceptors (for a variety of reasons), so even many of the preceptors they do manage to recruit aren't used to having students. A few of my rotations pretty much amounted to shadowing.

And yep, that's a good one. Nice catch.

 

[Winged Scapula]

I think that they get the option to either get paid or get CME credits, because I remember one of my attendings complaining that he needed to fill out some paperwork to get CME credit for hosting med students.

Most get both.

 

[prometheus09]

Most get both.

Just scanned the rest of this thread and saw you answered this question the best earlier. Missed it the first time around.

 

[Winged Scapula]

Just scanned the rest of this thread and saw you answered this question the best earlier. Missed it the first time around.

No worries. It's easy to miss stuff especially in the longer threads.

 

[Dr_IMG]

I think its absolutely ridiculous when programs write it as a residency app requirement, yet offer nothing at their own location.

Its a PC way to say, "We discriminate against IMGs, but not outwardly...so here's a hint." What are they afraid of?

If they don't want to take IMGs so be it, just say you only accept AMGs and be done with it.

Hi,
I am trying to find Rotations in US. I am a 2011 Graduated IMG. Can you please help me in finding some Academic based hospitals which provide Rotations? I am desperate to get into a program but can't find any help online

 

[Winged Scapula]

Hi,
I am trying to find Rotations in US. I am a 2011 Graduated IMG. Can you please help me in finding some Academic based hospitals which provide Rotations? I am desperate to get into a program but can't find any help online

The reason you're having difficulty is that no programs offer elective or core clinical rotations to someone who has already graduated medical school.

The only option you have at this point is an observation which are generally found by simply cold calling departments and or private practice positions.


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[KingD]

Although this thread hasn't been active for quite awhile I figured I'd still ask. Do physicians who receive a stipend for rotating medical students typically receive a W2?

 

[VA Hopeful Dr]

Although this thread hasn't been active for quite awhile I figured I'd still ask. Do physicians who receive a stipend for rotating medical students typically receive a W2?

It depends. If you work for the hospital system that has the medical school it can be extra W2 income.

Otherwise it's usually 1099.

 

[KingD]

Ah, I was figuring that would be the case. Was hoping it'd be possible to see a W2 from the school, while still working in private practice.