Psych salary...

[postbacpremed87]

You don't have to buy it, but I've seen it subjectively in my program. This year match we only matched U.S MD. No IMGs or DO. First time ever.

I am Canadian so I keep track of match stuff up north. Last year in Ontario, for the first time ever there were no psych spots in 2nd round.

So maybe it's all BS, but I dunno, I think it's shifting in our favor.

I'm pretty sure that competitive (avg. stats for the field) DO's who have shown an interest in psych need not worry as they enter the match.

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[Shikima]

That's nice and lean brother! Plenty of room for QOL updates. Time to hire another psychiatrist.

In the area where I'm practicing, I'm the youngest city wide and there isn't any other fresh blood moving in. Looking 5 years from now, I'm anticipating a loss of 1/3-1/2 of practicing, another 1/4 gone 3-4 years after that.

 

[postbacpremed87]

In the area where I'm practicing, I'm the youngest city wide and there isn't any other fresh blood moving in. Looking 5 years from now, I'm anticipating a loss of 1/3-1/2 of practicing, another 1/4 gone 3-4 years after that.

Definitely the right field to be entering now in terms of employment.

 

[Shikima]

Definitely the right field to be entering now in terms of employment.

I'm carefully positioning myself with the local hospital.

 

[heyjack70]

Where did all the middle aged psychiatrists go? Almost everyone around here is in their 50s or older. Some are still practicing in their 70s. Was there a huge decrease in the number of psychiatrists in residency 20 years ago? Why is it there seem to be plenty of old psychiatrists, but hardly any in their late 30s to 40s?

 

[WingedOx]

And here is an objective fact. I read in the Psychiatric Times April Issue, in this year's match, 13% increase in U.S graduates matching into Psych. That is the LARGEST increase in all specialities for U.S grads. According to the article, if this pace continues, Psychiatry will be all U.S Grads and no IMGs by 2018.

Just some food for thought.

sorry, had to.

 

[notdeadyet]

According to the article, if this pace continues, Psychiatry will be all U.S Grads and no IMGs by 2018.

For a specialty that was about half IMGs and DOs as recently as last year, I think they're Bering a bit optimistic.

Medical school slots have been rising at a rate much faster than residency slots. All specialties will find it getting more competitive. This will be felt most by IMGs, then by DOs. At the end of the day, psych may be getting more conpetetive more quickly, but that's as much a reflection of how uncompetitive our specialty is. We will always be one of the easier ones to match in.

I think folks will be less anxious about residency choice if they base it on the work they want to do rather than the ego stroke of thinking your specialty as competitive. That makes about as much sense as walking around happy because you're paying way more for rent than most.


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[postbacpremed87]

Where did all the middle aged psychiatrists go? Almost everyone around here is in their 50s or older. Some are still practicing in their 70s. Was there a huge decrease in the number of psychiatrists in residency 20 years ago? Why is it there seem to be plenty of old psychiatrists, but hardly any in their late 30s to 40s?

Great opportunity for folks entering the field now.

 

[postbacpremed87]

For a specialty that was about half IMGs and DOs as recently as last year, I think they're Bering a bit optimistic.

Medical school slots have been rising at a rate much faster than residency slots. All specialties will find it getting more competitive. This will be felt most by IMGs, then by DOs. At the end of the day, psych may be getting more conpetetive more quickly, but that's as much a reflection of how uncompetitive our specialty is. We will always be one of the easier ones to match in.

I think folks will be less anxious about residency choice if they base it on the work they want to do rather than the ego stroke of thinking your specialty as competitive. That makes about as much sense as walking around happy because you're paying way more for rent than most.


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Again, while we may not match at MGH/McLean, DO's are completely integrated into the field. It will continue to be a somewhat easier match (given avg. stats for the field), especially at lower-mid-tier university programs. If you are trying to match Psych in the next 5-10 years as a DO, then you should be fine.

 

[notdeadyet]

Again, while we may not match at MGH/McLean, DO's are completely integrated into the field.

Absolutely. In all fields of medicine, DOs and MDs have exactly the same practice rights.

That said, DOs have traditionally had a more uphill battle at more competitive specialties and programs. I don't see that changing.

What will be interesting is that if psych continues to become more competitive, as middle-of-the-road programs that traditionally took a good number of DOs, will this be less and less the case? Or will those same programs continue to take the same amount of DOs despite becoming more competitive, since they have field tested DOs and found them to be awesome? I have a hunch it will fall down to the personality of individual programs and we will see lots of both.

If you are trying to match Psych in the next 5-10 years as a DO, then you should be fine.

Absolutely. Even if psych becomes as competitive as folks here seem to think, there will always be plenty of good programs open to DOs. There are simply too many DOs that have done awesome work at these programs for that to change.

 

[postbacpremed87]

Absolutely. In all fields of medicine, DOs and MDs have exactly the same practice rights.

That said, DOs have traditionally had a more uphill battle at more competitive specialties and programs. I don't see that changing.

What will be interesting is that if psych continues to become more competitive, as middle-of-the-road programs that traditionally took a good number of DOs, will this be less and less the case? Or will those same programs continue to take the same amount of DOs despite becoming more competitive, since they have field tested DOs and found them to be awesome? I have a hunch it will fall down to the personality of individual programs and we will see lots of both.

Absolutely. Even if psych becomes as competitive as folks here seem to think, there will always be plenty of good programs open to DOs. There are simply too many DOs that have done awesome work at these programs for that to change.

We are talking Psychiatry and I do not think it is all that difficult to match (maybe I will be blindsided in the match - who knows). Psych will become more competitive, but the increase in competitiveness will lag behind other specialties. So many medical students state that they could never do psychiatry. I am a top student at my school and whenever I mention my interest in Psych, they get this look on their face (Why would a top student choose Psych?). Students will be miserable if they get thrown into the field because they could not get anything else. I think Psych will always be one of the easiest 4-5 residencies to get into. I am okay with that!

 

[MacDonaldTriad]

Stop the presses; psychiatry has become 13% more popular among domestic allopathic graduates! This means that we have gone from 3% of graduates to 3.39%.
As wingedOx points out, we should all buy into our wedding planner’s loyalty programs.
In a normal life span psychiatry could become 48% harder to get into!

 

[W19]

Things are about to get very difficult in psych. Therefore, I just started looking at community programs and programs that have mostly IMG... I have seen some in the south that have 80%+ IMG.

 

[postbacpremed87]

Things are about to get very difficult in psych. Therefore, I just started looking at community programs and programs that have mostly IMG... I have seen some in the south that have 80%+ IMG.

Slightly contradictory. It's all relative. It will not become VERY difficult unless you are a bottom of the barrel candidate who could once rely on Psych as your last refuge. An applicant with average stats/proven interest in psych will match. I think these are all positive developments.

 

[W19]

Slightly contradictory. It's all relative. It will not become VERY difficult unless you are a bottom of the barrel candidate who could once rely on Psych as your last refuge. An applicant with average stats/proven interest in psych will match. I think these are all positive developments.

It's not contradictory because these are classes of 2010-2014 when psych was not competitive... I think by the time you and I are ready to apply (2017-2018), psych average step 1 will be in the 230s...

 

[postbacpremed87]

It's not contradictory because these were past match when psych was not competitive... I think by the time you and I are ready to apply (2017-2018), psych average step 1 will be in the 230s...

I think the word I had difficulty with was very. We will go from an uncompetitive situation where programs match 80%+ IMGs to maybe a few IMGs. Very competitive for them, but not for us or certainly not MD applicants. We will be absolutely fine. We can play the numbers game - I think it will reach 226 by the time we apply. This is still below the current average.

 

[whopper]

It goes in trends. There's more applicants this year but there have been previous periods where an upshot trend occurred for about 1-3 years then it fell off again. I have noticed more people interested at least among the medstudents this year. The medstudents with me told me that this particular year among the PGY IIIs there were many more people interested in psych.

I don't know if this change is due to a trend or it's coincidence. I do think that there is an ever-increasing awareness and sensitivity to mental illness that occurred since the 90s, the science behind psychiatry has vastly improved to the degree where it may be catching more interest among the more technical-minded medstudents, and that more medstudents are being turned off by the idea of being in a profession for decades where they might never catch a good night's sleep.

 

[MacDonaldTriad]

I have it on good authority that the % of medical students going into psychiatry varies directly in proportion to Punxsutawney Phil’s prediction of long winters vs. early Springs. Go figure.

 

[Dharma]

It's not contradictory because these are classes of 2010-2014 when psych was not competitive... I think by the time you and I are ready to apply (2017-2018), psych average step 1 will be in the 230s...

No way. Average 230s for the average USMLE across the board, definitely. But not average psych step 1. Let's not make too many assumptions here. It's not like all of sudden psych became so competitive in 2015.

 

[Blitz2006]

I dunno, I wouldn't be surprised if in 2018 match the average is in the 230s.

Look at the charting outcomes for 2011 and 2014.

In 2011, Psych Avg. was 214
In 2014, Psych Avg. was 220

So an average of increase of 2 each year. Whereas other 'competitive specialities' (ie. ENT, Radiology), hovered around low 240s (no change in those 3 years). While the overall USMLE average is climbing.

This year, there was a 13% increase in U.S applicants (largest increase across all specialities). So I think its safe to say the 2015 average went up again by 2 points, and maybe even more, so easily 223-224.

So if the trend continues, I would say by 2018 match, the average could very easily be 230-232.

I mean, this thread alone has opened my eyes, and I'm a Psych intern. If medical students become aware quickly that you can realistically make 350-400K with no nights/weekends/little on-call/great job market/low overhead/low malpractice, then that 3% number is going to skyrocket. Medical students have no knowledge about malpractice or overhead costs. When I tell med students that OBGYN pay 180-200K in malpratice in the NYC area, they are shocked, or that optho has an average overhead cost of 35-40%, they are in disbelief. Meanwhile guys like Shikima are cookin' with 20% overhead. Impressive.

Just this week I had a medical student who was gun-ho about cardiology. But after I spent some time with him, and told him some of the stuff we have been discussing on this thread, he is actually seriously considering psych. I think the fact that he cringes everytime he hears "CODE STEMI" overheaded also helps my arguments for psych

So yes, W19 has some validity with his worries. I don't think by 2018 (as the article stated) that there will be NO spots for DO/IMGs, but I think it will be almost impossible for DO/IMGs to match into 2nd tier university programs, whereas 5 years ago you just needed below average to average USMLE scores and you would walk into a match.

Again, just my 2 cents, but its fun to talk about this stuff, and exciting for our field.

No way. Average 230s for the average USMLE across the board, definitely. But not average psych step 1. Let's not make too many assumptions here. It's not like all of sudden psych became so competitive in 2015.

 

[Blitz2006]

We are talking Psychiatry and I do not think it is all that difficult to match (maybe I will be blindsided in the match - who knows). Psych will become more competitive, but the increase in competitiveness will lag behind other specialties. So many medical students state that they could never do psychiatry. I am a top student at my school and whenever I mention my interest in Psych, they get this look on their face (Why would a top student choose Psych?). Students will be miserable if they get thrown into the field because they could not get anything else. I think Psych will always be one of the easiest 4-5 residencies to get into. I am okay with that!

I agree 100% with what you said. But as I mentionned in my post above, I think people say that about psychiatry because medical students are clueless about psych. Here they just do 4 weeks of psych (2 weeks CL, 2 weeks Inpatient). They have ZERO exposure to stuff like addiction psych, child psych, forensics, neuropsychiatry. When I tell them about neuropsych fellowships, neuroimaging, FMRIs, PET scans, correlating behavior with neuroradiology studies, they are shocked and fascinated about how cutting edge psychiatry can be. Its because our medical schools don't expose students to all the elements of psychiatry, imho. They just see the consult dumps or crappy inpatient facilities and think that is psych, which is far from glamorous. Of course I am generalizing, but that is my general observation.

and of course reimbursement. People read Medscape and see that psychiatry averages 198K or 210K or whatever, and see its 4th last on the list. Versus Ortho/Cards which has numbers of 350K or whatever. Little do they know that psych numbers are deflated for reasons we all know here on this forum.

 

[postbacpremed87]

I agree 100% with what you said. But as I mentionned in my post above, I think people say that about psychiatry because medical students are clueless about psych. Here they just do 4 weeks of psych (2 weeks CL, 2 weeks Inpatient). They have ZERO exposure to stuff like addiction psych, child psych, forensics, neuropsychiatry. When I tell them about neuropsych fellowships, neuroimaging, FMRIs, PET scans, correlating behavior with neuroradiology studies, they are shocked and fascinated about how cutting edge psychiatry can be. Its because our medical schools don't expose students to all the elements of psychiatry, imho. They just see the consult dumps or crappy inpatient facilities and think that is psych, which is far from glamorous. Of course I am generalizing, but that is my general observation.

and of course reimbursement. People read Medscape and see that psychiatry averages 198K or 210K or whatever, and see its 4th last on the list. Versus Ortho/Cards which has numbers of 350K or whatever. Little do they know that psych numbers are deflated for reasons we all know here on this forum.

but shhhhhhhhhh!

 

[Dharma]

... but I think it will be almost impossible for DO/IMGs to match into 2nd tier university programs.

That's a stretch.

No DO/IMG exciting huh?

 

[Dharma]

If medical students become aware quickly that you can realistically make 350-400K with no nights/weekends/little on-call/great job market/low overhead/low malpractice,.

And if they believe that they will likely be disappointed by reality. Outliers make that loot, not the average psychiatrist. Most of us will end up someplace in that land of average.

 

[psych md jd]

If medical students become aware quickly that you can realistically make 350-400K with no nights/weekends/little on-call/great job market/low overhead/low malpractice, then that 3% number is going to skyrocket.

It’s not how much money you make, but how much money you keep, how hard it works for you, and how many generations you keep it for. –Robert Kiyosaki

I love money. I love everything about it. I bought some pretty good stuff. Got me a $300 pair of socks. Got a fur sink. An electric dog polisher. A gasoline powered turtleneck sweater. And, of course, I bought some dumb stuff, too. –Steve Martin

A few years ago I was making 400k+/year. Now, I'm much happier being average.

 

[heyjack70]

I think $400,000 per year is a busy job with long days and working at least one weekend a month inpatient or alternate moonlighting. If you can open a cash practice and make that money in 40 hours a week or less more power to you.

 

[MrWonderful]

I'm curious to hear about people's experiences setting up shop with their own private practice. I'm interested in different business models utilizing other behavioral therapists and the like. Can anybody describe their experience? Anything will do I like the business aspect of medicine a lot

 

[psych md jd]

I think $400,000 per year is a busy job with long days and working at least one weekend a month inpatient or alternate moonlighting.

Not in my case: 44 hours/week, all outpatient, all telepsych, no weekends, no call, no moonlighting, a lot of stress.

 

[hamstergang]

When I tell them about neuropsych fellowships, neuroimaging, FMRIs, PET scans, correlating behavior with neuroradiology studies, they are shocked and fascinated about how cutting edge psychiatry can be.

What neuroimaging do you do in psychiatry?

 

[heyjack70]

Not in my case: 44 hours/week, all outpatient, all telepsych, no weekends, no call, no moonlighting, a lot of stress.

Stress? How many patients per hour?

 

[postbacpremed87]

So yes, W19 has some validity with his worries. I don't think by 2018 (as the article stated) that there will be NO spots for DO/IMGs, but I think it will be almost impossible for DO/IMGs to match into 2nd tier university programs, whereas 5 years ago you just needed below average to average USMLE scores and you would walk into a match.

So all of the program directors that have DO after their name at those "2nd tier" universities will suddenly be fired or suddenly not want to see students with their own degree? There are quite a few program directors with the DO degree. Are you sure you don't have some deep seeded hatred of DOs? Nothing you have said has any basis in fact. There is no way that the average for psych will be in the 230s. You say it so freely like it will be true. It won't. DOs aren't going anywhere. They will continue to match your "2nd tier" and some will match 1st tier. I think IMGs will become less frequent however.

 

[Freddie Mercury]

If medical students become aware quickly that you can realistically make 350-400K with no nights/weekends/little on-call/great job market/low overhead/low malpractice, then that 3% number is going to skyrocket.

For the next 10 months can we please do nothing but complain about how terrible psych is?

-Freddie Mercury, MD class of 2016

 

[675015]

What neuroimaging do you do in psychiatry?

All the best psychiatrists do PETs and fMRIs on every patient no?

 

[splik]

All the best psychiatrists do PETs and fMRIs on every patient no?

Amen to that!

 

[Blitz2006]

Lol. You are joking me. Deep seeded hatred for DO?

Some of the best psychiatry residents and attendings I have worked with are DOs. I personally have no issues with DOs and IMGs, especially since I'm an IMG myself.

But the fact is there is stigma against IMGs and DOs, whether you want to believe it or not. I was obviously generalizing about 2nd tier not taking DOs. There will always be a few that will match. My point was that it is trending in a direction where it will be almost it will be impossible for DOs/IMGs to match in the future, as it is the nature of the matching game.

I am sure there are very capable DO students who are capable of doing MD derm and ENT residencies, but how many DO do you see matching into that? Same reason, stigma. Just like how a carribean IMG with a score of 250 will still be passed by US MD with a score of 240 for a derm spot because of stigma.

Again I am generalizing, but that is the nature of the match, unfortunately.

And I love how you claim I am anti DO and then say at the end "IMG will be less frequent".

I am sure an IMG from Oxford or Cambridge would be exceptional candidate.

So all of the program directors that have DO after their name at those "2nd tier" universities will suddenly be fired or suddenly not want to see students with their own degree? There are quite a few program directors with the DO degree. Are you sure you don't have some deep seeded hatred of DOs? Nothing you have said has any basis in fact. There is no way that the average for psych will be in the 230s. You say it so freely like it will be true. It won't. DOs aren't going anywhere. They will continue to match your "2nd tier" and some will match 1st tier. I think IMGs will become less frequent however.

 

[675015]

Lol. You are joking me. Deep seeded hatred for DO?

Some of the best psychiatry residents and attendings I have worked with are DOs. I personally have no issues with DOs and IMGs, especially since I'm an IMG myself.

But the fact is there is stigma against IMGs and DOs, whether you want to believe it or not. I was obviously generalizing about 2nd tier not taking DOs. There will always be a few that will match. My point was that it is trending in a direction where it will be almost it will be impossible for DOs/IMGs to match in the future, as it is the nature of the matching game.

I am sure there are very capable DO students who are capable of doing MD derm and ENT residencies, but how many DO do you see matching into that? Same reason, stigma. Just like how a carribean IMG with a score of 250 will still be passed by US MD with a score of 240 for a derm spot because of stigma.

Again I am generalizing, but that is the nature of the match, unfortunately.

And I love how you claim I am anti DO and then say at the end "IMG will be less frequent".

I am sure an IMG from Oxford or Cambridge would be exceptional candidate.

You really like the word stigma huh?

 

[postbacpremed87]

And I love how you claim I am anti DO and then say at the end "IMG will be less frequent"

Because the majority of the posters that visit this forum agree that IMGs will have an extraordinary burden (even more than now) on them to match. Most PDs prefer DOs over IMGs (not at top top programs but more programs overall). I'd rather be a DO matching in the next decade...not an IMG. I just want the best candidate to match. I could care less where one comes from. I'm simply stating the reality on the ground. As the years progress, IMGs will have a tougher time matching in all specialties...including Psych.

With all that being said, let us get back to the main point I have been trying to drive home. In the next 5-10 (whether you are a Harvard MD, DO, Costa Rica IMG), if you have the scores, apply broadly, demonstrate an interest in Psych, then you will match! I think those folks that use it as a last refuge to match will find themselves out of luck.

 

[Dharma]

Trending nonsense. Dude just used derm to support his argument regarding psych. Ok！
Moving on...

 

[Trismegistus4]

Does anyone have any good resources on understanding this RVU stuff? I interviewed for an inpatient job and, while I didn't like the job anyway and thus didn't want it, would have had no idea how to negotiate salary since I would have had no idea how much revenue I'd be generating.

 

[psych md jd]

From http://www.practicelink.com/magazine/featured/how-will-you-get-paid/

"RELATIVE VALUE UNITS: RVUs are a way in which a service or procedure is valued and payment made to the physician; there are two kinds, total and work. The work RVU is generally used in bonus models and is a unit of measure that expresses the amount of time, intensity, effort and technical skills required to perform a specific service. Total RVU consists of the work RVU and overhead costs and malpractice expense. There are published schedules of both work and total RVUs."
​

Also info at http://www.psychiatrictimes.com/rvu/calculate-your-rvu-payment