Does prestige in residency position translate into higher income?

[kwb18200]

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My question is, within any given specialty, (say, anesthesiology) would the prestige of residency position translate into future greater income as a practicing physician? Does this change from specialty to specialty?

If the prestige of a residency position does not generally translate into future greater income, what advantages does it confer? I have heard, for instance, the prestige of a residency position matters more when entering academia.

 

[DrStephenStrange]

Prestige usually matters for people wanting to go into academia. People in academia usually make much less. Prestige also matters for future fellowship options after residency. As long you don't go into academia your salary potential is pretty much the same as anyone in the same field regardless of where they did their residency. Experience will matter more in the long run.

 

[voxveritatisetlucis]

no

 

[Davidfromcali]

Prestigious programs can help you break into very desirable markets where the most desirable PP groups are. In gas, going to a place like Stanford or UCLA is gonna help you get your foot in the door for the practices in coastal SoCal that tend to recruit via word of mouth.

 

[collegestud2013]

My question is, within any given specialty, (say, anesthesiology) would the prestige of residency position translate into future greater income as a practicing physician? Does this change from specialty to specialty?

If the prestige of a residency position does not generally translate into future greater income, what advantages does it confer? I have heard, for instance, the prestige of a residency position matters more when entering academia.

Besides academia, it can help to build connections to land more desirable community jobs. This is especially the case in specialties with tight job markets such as EM or radiation oncology. Someone coming from a "no-name" community program in these specialties can have a very tough time finding a decent job as a new grad, especially if it's not in their region and if they don't have connections.

 

[voxveritatisetlucis]

Prestigious programs can help you break into very desirable markets where the most desirable PP groups are. In gas, going to a place like Stanford or UCLA is gonna help you get your foot in the door for the practices in coastal SoCal that tend to recruit via word of mouth.

Yes but won’t one still make less in those markets regardless of group

 

[RangerBob]

No.

Just being honest, but the people from top residency programs tend to be more difficult to work with, so in our small town where everyone knows one another and has to work together, we just don’t get or retain many “top tier” folks.

That said, there is literally a farm down the street from my hospital. High school in one side, farm on the other. So maybe we’re not the type of place ivy leaguers want to go. But year round sunshine and temps in the 60-80’s is nice! If only we weren’t in a drought like the rest of CA. Duluth, MN is looking real good right now…

 

[KnightDoc]

Yes but won’t one still make less in those markets regardless of group

Because everyone in a given specialty in a given market makes exactly the same? Just like everyone at a given med school pays the same, no matter where they attended UG or what their stats are? 🙂

I understand insurance reimbursement rates don't vary based on the name of the institution on the framed piece of paper on the wall in your office, or where you did a residency or fellowship, but I'm not so sure the fancy practices recruiting out of the fancy residencies and fellowships don't pay up to get who they want. Just like anywhere else in any other field.

I guess I'll see when the time comes. I have a long way to go and I need to get there first, but I have to assume there is a reason so many people chase so few programs, in any given specialty, beyond dreams of academia and impressing the family.

 

[Dr G Oogle]

I don’t think so. For academics your research out is what matters, all things being equal prestige might win out, but all things are never equal. Though being from a prestigious program can sometimes afford more opportunity for more research output. For PP networking matters and more prestigious places probably have more robust alumni networks who might more likely take people from their own program, but that doesn’t necessarily translate to more income just more likely to get a job in competitive market. You’re much more likely to make a better wage in rural america than on the coasts

 

[Browns99]

Prestigious programs can help you break into very desirable markets where the most desirable PP groups are. In gas, going to a place like Stanford or UCLA is gonna help you get your foot in the door for the practices in coastal SoCal that tend to recruit via word of mouth.

My question is, within any given specialty, (say, anesthesiology) would the prestige of residency position translate into future greater income as a practicing physician? Does this change from specialty to specialty?

If the prestige of a residency position does not generally translate into future greater income, what advantages does it confer? I have heard, for instance, the prestige of a residency position matters more when entering academia.

It absolutely will translate into more money because it is likely to lead to more opportunities in bigger markets which translates into more money. And while true that those from less prestigious residencies will make the same money in those same places, it's more about the opportunities that someone coming out of a prestigious residency will have and thus allow them to make more money.

 

[mistafab]

It absolutely will translate into more money because it is likely to lead to more opportunities in bigger markets which translates into more money. And while true that those from less prestigious residencies will make the same money in those same places, it's more about the opportunities that someone coming out of a prestigious residency will have and thus allow them to make more money.

Bigger markets pay less bro.

NYC, california, DC, etc… all in the gutter in terms of compensation when compared to COL.

At least in psychiatry, pay is more related to location rather than prestige. In private practice, it’s more marketing/business skills than prestige as well - though you may use your prestige in your marketing… getting employed anywhere means less money for you though in psychiatry (self employed = more money).

In psychiatry, prestige helps with academic appointment, opportunities for reasearch, and bias towards fellowship. I imagine for other specialties it is the same (tufts grad easier to get into cards fellowship than some random community program) which may translate into more money. In psych, fellows dont earn more.

 

[Browns99]

Bigger markets pay less bro.

NYC, california, DC, etc… all in the gutter in terms of compensation when compared to COL.

At least in psychiatry, pay is more related to location rather than prestige. In private practice, it’s more marketing/business skills than prestige as well - though you may use your prestige in your marketing… getting employed anywhere means less money for you though in psychiatry (self employed = more money).

In psychiatry, prestige helps with academic appointment, opportunities for reasearch, and bias towards fellowship. I imagine for other specialties it is the same (tufts grad easier to get into cards fellowship than some random community program) which may translate into more money. In psych, fellows dont earn more.

You missed the point entirely bro.......It was about the opportunities in markets (which will translate to more money) for residents coming from prestigious residencies. Please take your time in the future when responding to posts.

BTW, bigger markets does not only mean geographical areas like, NYC, Cal, etc.......it also means markets that can fetch big money, whether that is in Oklahoma or NYC.

 

[Goro]

My question is, within any given specialty, (say, anesthesiology) would the prestige of residency position translate into future greater income as a practicing physician? Does this change from specialty to specialty?

If the prestige of a residency position does not generally translate into future greater income, what advantages does it confer? I have heard, for instance, the prestige of a residency position matters more when entering academia.

Nope. My DO students who did residencies at community hospitals are pulling in the same as their peers who went to major academic programs.

 

[ZenArcher35]

Agree with no, but very much yes on the ability to break into good opportunities in competitive markets, like in the bay area/socal. Or get into prestigious academic places, if academics is the goal.

And yes, CA or NYC may pay less than a more rural area in the midwest, but for a lot of dumb people including myself, there's just no way living in non-CA/NYC/etc would bring happiness.

 

[operaman]

It certainly opens doors but rarely if ever leads to much difference in income. If anything, grads from top programs probably earn a bit less because they’re more likely to take top academic jobs that pay well below median. It may help land a private job in a tough market, but then those too are typically going to pay less than others.

The people that make the most are the ones who have good business skills and are good managing finances. They’re the ones opening surgery and imaging centers, med spas, cosmetic side gigs, etc. I think the skill set required for physician entrepreneurship is different than the one for climbing the academic ladder, so you probably don’t see so many top program grads striking out on their own like that. They’re too busy publishing papers in JAMA and NEJM and competing for that entry level Ivy League assistant professor job or Bay Area private practice job paying $175k.

 

[DOVinciRobot]

but I'm not so sure the fancy practices recruiting out of the fancy residencies and fellowships don't pay up to get who they want. Just like anywhere else in any other field.

That’s not how it works. Typically they pay less…

You missed the point entirely bro.......It was about the opportunities in markets (which will translate to more money) for residents coming from prestigious residencies. Please take your time in the future when responding to posts.

BTW, bigger markets does not only mean geographical areas like, NYC, Cal, etc.......it also means markets that can fetch big money, whether that is in Oklahoma or NYC.

You’re still wrong. The opportunities don’t change based on the prestige of your residency. I’m in talks with a highly selective private group right now, in a very competitive market. You know why? It’s because I’m from the area and know them. They literally don’t hire people without ties to the area regardless about how fancy their residency is.

I hate to break to many of you but in the private practice world no one cares how prestigious your residency was. They want to know if they can work well with you and that you’ll work hard to build the practice.

 

[voxveritatisetlucis]

I also forgot that it might matter if you want to go into hospital administration. The background of many admins around here is HMS/JHU/Penn —> MGH/BWH —> some fellowship —> professor —> department chair —-> admin

 

[ZenArcher35]

That’s not how it works. Typically they pay less…

You’re still wrong. The opportunities don’t change based on the prestige of your residency. I’m in talks with a highly selective private group right now, in a very competitive market. You know why? It’s because I’m from the area and know them. They literally don’t hire people without ties to the area regardless about how fancy their residency is.

I hate to break to many of you but in the private practice world no one cares how prestigious your residency was. They want to know if they can work well with you and that you’ll work hard to build the practice.

Hard to make a blanket statement like that (hate to break it to you). I'm sure there are different practices that operate differently, and I have a personal anecdote that could say the opposite. But yes, if you have a personal connection with a practice, that probably trumps most other factors (though I don't think you can expect the average person to have something like that).

I think the most generalizable statement is that going to the most prestigious residency in your desired location of practice is the most strategic move. And if your goal is a bougie practice in manhattan or whatever, then barring any personal connections or crummy personalities, the person from NYU or Cornell is most likely at an advantage compared to a local community program (or even other top-tier but not local programs), both from the brand perspective and being able to tap into the programs' respective local networks of connections.

 

[Ho0v-man]

The opportunities for academia are obvious. And reimbursement is the same no matter where you train.

But for PP, going to a prestigious residency is basically making yourself a “known product” no matter where you go. If you go to a top program in your field, you can apply wherever and no matter where that is people will still assume you’re “well-trained”.

That being said, the most well-known product is the person 20 miles away who did residency at the place half the people in the group trained. So the argument could be made that just going to a solid, but less prestigious program is the better bet if it’s in the region you want to be.

But let’s say that red hot job market you remember as a med student is looking a little frosty when residency is over. If there’s no jobs where you want to be, then you have to look out of your region. You’re now trying to get in with groups who’ve never heard of your program. But everyone’s heard of Hopkins. Think you’ll get the job over them?

So going for prestige is a great way to not geographically restrict yourself and hedge your bets if the job market goes south.

 

[AClassicRisetotheOccasion]

In my humble opinion, making $$$ money depends on many factors: The most important would be the location of the job, the scarcity of physicians in that location, whether you have specialized training or experience in a niche field, your personality, and whether you are a team player.

 

[DOVinciRobot]

Hard to make a blanket statement like that (hate to break it to you). I'm sure there are different practices that operate differently, and I have a personal anecdote that could say the opposite.

It’s not hard to make that statement and I stand by it.

If people are looking to go into private practice they should go to a program that has the reputation of producing clinically solid graduates. Maybe that’s the big prestigious academic center, but many times it’s not.

 

[Dr G Oogle]

You missed the point entirely bro.......It was about the opportunities in markets (which will translate to more money) for residents coming from prestigious residencies. Please take your time in the future when responding to posts.

BTW, bigger markets does not only mean geographical areas like, NYC, Cal, etc.......it also means markets that can fetch big money, whether that is in Oklahoma or NYC.

In Oklahoma, you’re more likely to get patients by being home grown than being from one of them there liberal elite coastal places

 

[CannedPineapple]

It’s not hard to make that statement and I stand by it.

If people are looking to go into private practice they should go to a program that has the reputation of producing clinically solid graduates. Maybe that’s the big prestigious academic center, but many times it’s not.

Count yourself lucky on your situation. It's simply not true though that every private practice out there doesn't care about prestige, whether we like it or not (and I wish it was unilaterally not the case). Guiding people that this doesn't happen though is naive.

Your point about academic centers not necessarily giving the best clinical training is a good one, albeit completely separate from the previous discussion items - and I really do think people should consider that more.

 

[DOVinciRobot]

Count yourself lucky on your situation. It's simply not true though that every private practice out there doesn't care about prestige, whether we like it or not (and I wish it was unilaterally not the case). Guiding people that this doesn't happen though is naive.

The only instances I’ve ever heard of a private practice caring are in massive coastal cities. I will fully admit I have never had any interest in those particular markets, but for anywhere between the coasts the vast majority of practices do not care. They care that you are well trained, and they are often very familiar with which programs produce competent physicians in their area.

To be 100% fair I’m in general surgery, where the clinical skill set out of training is vitally important for a new private group.

 

[Medstart108]

I think the most important thing is you as an individual, we aren't in silos. If you took the same person and put them in a no name community program vs an ivy league academic program, there likely would be a difference in terms of what their training would lead them towards. Could just be the exposure they get in residency that inspires them one way or another. But, if you were a betting man, you would be better off at the more prestigious program.

At the same time the difference between academic programs that are maybe one or two tiers away from each other is probably pretty similar and any difference in job opportunities is likely more related to the regional networks they develop.

 

[operaman]

The only instances I’ve ever heard of a private practice caring are in massive coastal cities. I will fully admit I have never had any interest in those particular markets, but for anywhere between the coasts the vast majority of practices do not care. They care that you are well trained, and they are often very familiar with which programs produce competent physicians in their area.

To be 100% fair I’m in general surgery, where the clinical skill set out of training is vitally important for a new private group.

I agree with your stance 100%.

I think where some are getting confused is that we are having two parallel yet distinct discussions:

1) does residency prestige lead to higher PAY?

2) does residency prestige lead to more JOB options?

Two vastly different discussions yet overlapping in this thread. Prestige definitely opens more doors to more jobs. Usually those jobs pay less than others because they can.

 

[RangerBob]

Agree with no, but very much yes on the ability to break into good opportunities in competitive markets, like in the bay area/socal. Or get into prestigious academic places, if academics is the goal.

And yes, CA or NYC may pay less than a more rural area in the midwest, but for a lot of dumb people including myself, there's just no way living in non-CA/NYC/etc would bring happiness.

Solution: Rural(ish) CA 🙂

Speaking as a CA-raised kid who now works/lives again in CA (in a more rural part), but spent 9 years living/training in the Midwest, it's actually not as bad out there as we're raised here to believe. I grew up thinking anything between the coasts was "flyover country" and miserably cold, unfriendly, un-diverse (that one is definitely true depending where you go) and well, just plain miserable. I was actually pleasantly surprised at how nice those flyover states were, how friendly people were, and how your body can adjust to the miserably cold weather.

I particularly liked the Great Lakes region (specifically MN/WI/MI) I actually offered to buy my family a home there. It would have been cheaper to buy them all a home there than for me to buy one in CA. But they had no interest in leaving CA, so here I am now with my (now)-$1million "doctor" home in CA, which really just means tract housing from the 80's that would cost ~$200k elsewhere. I'm very happy here, but I would honestly be just as happy if my family were in the Midwest. Probably not if they were in the South/TX/FL--it's just too hot/humid there and that would just make me grumpy all the time...

 

[qwerty89]

Prestigious programs can help you break into very desirable markets where the most desirable PP groups are. In gas, going to a place like Stanford or UCLA is gonna help you get your foot in the door for the practices in coastal SoCal that tend to recruit via word of mouth.

Physicians - Newport Harbor Anesthesia Consultants Medical Group, Inc.

HOMEABOUTABOUT USPHYSICIANSHIRE NHAC FOR YOUR ASCINSURANCEBILLINGFAQTYPES OF ANESTHESIAQ&AHIPAACONTACT US HOMEABOUTABOUT USPHYSICIANSHIRE NHAC FOR YOUR ASCINSURANCEBILLINGFAQTYPES OF ANESTHESIAQ&AHIPAACONTACT USAt Newport Harbor Anesthesia Consultants, patient care is our top...

www.newportharboranesthesia.com

Excellent payor mix. No CRNAs.

 

[Browns99]

That’s not how it works. Typically they pay less…

You’re still wrong. The opportunities don’t change based on the prestige of your residency. I’m in talks with a highly selective private group right now, in a very competitive market. You know why? It’s because I’m from the area and know them. They literally don’t hire people without ties to the area regardless about how fancy their residency is.

I hate to break to many of you but in the private practice world no one cares how prestigious your residency was. They want to know if they can work well with you and that you’ll work hard to build the practice.

That’s not how it works. Typically they pay less…

You’re still wrong. The opportunities don’t change based on the prestige of your residency. I’m in talks with a highly selective private group right now, in a very competitive market. You know why? It’s because I’m from the area and know them. They literally don’t hire people without ties to the area regardless about how fancy their residency is.

I hate to break to many of you but in the private practice world no one cares how prestigious your residency was. They want to know if they can work well with you and that you’ll work hard to build the practice.

So says you, "I hate to break to many of you"....That's an envious statement if you ask me and the absolute that "no one cares" is another example of you being 100% wrong because you couldn't possibly know that. I get the animosity toward the big programs when you did not attend one. I truly understand the bias and I'm not trying to put you down, just don't agree.

Again, if you read the post you would have understood that the point was about opportunity coming from prestigious programs, and you saying in your other statement that "the opportunities don’t change based on the prestige of your residency" is laughable to be honest.

 

[mike-sheree]

My question is, within any given specialty, (say, anesthesiology) would the prestige of residency position translate into future greater income as a practicing physician? Does this change from specialty to specialty?

If the prestige of a residency position does not generally translate into future greater income, what advantages does it confer? I have heard, for instance, the prestige of a residency position matters more when entering academia.

As a retired private practice doc who hired people over a number of years - - - no.
I was more interested in personality ( the 3 “A’s”- - - affability, availability and ability) and work ethic ( will you do anything that the group needs and do it cheerfully). Also, prior INDEPENDENT sign-out experience was paramount.
This largely exclude folks fresh out of fellowship(s) or residency. They have no meaningful experience in that regard.

 

[Hzreio]

So says you, "I hate to break to many of you"....That's an envious statement if you ask me and the absolute that "no one cares" is another example of you being 100% wrong because you couldn't possibly know that. I get the animosity toward the big programs when you did not attend one. I truly understand the bias and I'm not trying to put you down, just don't agree.

Again, if you read the post you would have understood that the point was about opportunity coming from prestigious programs, and you saying in your other statement that "the opportunities don’t change based on the prestige of your residency" is laughable to be honest.

Bruh the title of the post literally is referring to higher income

 

[Browns99]

Bruh the title of the post literally is referring to higher income

Bruh, stay with me here. The post morphed into discussing the benefits of having greater opportunities in general coming from a prestigious residency. My goodness, that is all that is being said.

 

[Hzreio]

Bruh, stay with me here. The post morphed into discussing the benefits of having greater opportunities in general coming from a prestigious residency. My goodness, that is all that is being said.

Whatever “benefits” prestige gets you, the income is the end goal. So, if the income is the same, then talking about the benefits is sort of a moot point.

Also, I will say, I’ve never heard any attending complain that they can’t find a good job because their institution was not “prestigious” enough…

 

[voxveritatisetlucis]

Physicians - Newport Harbor Anesthesia Consultants Medical Group, Inc.

HOMEABOUTABOUT USPHYSICIANSHIRE NHAC FOR YOUR ASCINSURANCEBILLINGFAQTYPES OF ANESTHESIAQ&AHIPAACONTACT US HOMEABOUTABOUT USPHYSICIANSHIRE NHAC FOR YOUR ASCINSURANCEBILLINGFAQTYPES OF ANESTHESIAQ&AHIPAACONTACT USAt Newport Harbor Anesthesia Consultants, patient care is our top...

www.newportharboranesthesia.com

Excellent payor mix. No CRNAs.

True but there are also UCI, Iowa, Loma Linda grads there. Also is there really even such a thing as prestige in anesthesiology? Even MGH and UCLA have a DO here and there on the roster whereas IM there are none.

Thing that stands out most to me is the number of dual residency physicians. Couple EM way before the EM bubble burst

 

[DOVinciRobot]

So says you, "I hate to break to many of you"....That's an envious statement if you ask me and the absolute that "no one cares" is another example of you being 100% wrong because you couldn't possibly know that. I get the animosity toward the big programs when you did not attend one. I truly understand the bias and I'm not trying to put you down, just don't agree.

I don’t have animosity towards top programs. Many people on SDN live in a prestige echo chamber without ever considering/realizing that prestige isn’t some hallmarker of success in every career path. Programs are designed to produce specific types of graduates and if that goal does not align with your career goals then your opportunities may in fact be decreased if you choose the fancy name. In my field the publicly stated mission of many top programs is to produce academic surgeons. They openly discourage private practice and their residents openly advertise how you will need to do a fellowship after the residency to build your clinical skills (but you’ll have 10+ papers and whatever academic fellowship you want waiting for you).

As I’ve stated many times, and I stand by those statements, the private practice world is different. It doesn’t give a rip how fancy your pedigree is. It wants to know if you are a hard worker who can produce and work well with the practice.

Notice I’m not saying to go to any old random program either, but to go to the most clinically strong program you can that has a reputation of producing high quality community physicians. Maybe that’s the highly academically prestigious program, but in many specialties it’s not.

Again, if you read the post you would have understood that the point was about opportunity coming from prestigious programs, and you saying in your other statement that "the opportunities don’t change based on the prestige of your residency" is laughable to be honest.

Again, in academia absolutely. In terms of income and private practice? No. I stand by my statements, your opportunity is going to be greater going to a known clinically strong program if your end goal is private practice than if you went to a top ranked academic program.

As to the thread topic income is not related to prestige unless you become a department chair or something.

 

[notretired]

I also forgot that it might matter if you want to go into hospital administration. The background of many admins around here is HMS/JHU/Penn —> MGH/BWH —> some fellowship —> professor —> department chair —-> admin

Really? I thought that pathway to admin was: be the son/daughter of current CEO ---> 4yr BA from Univ. of Phoenix ---> CEO

 

[Med Ed]

Really? I thought that pathway to admin was: be the son/daughter of current CEO ---> 4yr BA from Univ. of Phoenix ---> CEO

No, the BA comes from a party school of great renown. The MBA comes from Univ. of Phoenix.

 

[Dr G Oogle]

Bruh, stay with me here. The post morphed into discussing the benefits of having greater opportunities in general coming from a prestigious residency. My goodness, that is all that is being said.

Here’s the long and short of it. Prestigious programs might give you some tangible benefits: more opportunities for research and later academic success measured by grants, publications and perhaps a higher probability of becoming a department chair; may increase rate of being invited to scientific advisor boards and working with industry but majority of companies actually prefer to work with PP and in not name brand places because they usually lack the administrative behemoths that make starting these kinds of relationships very difficult, and lastly being in a prestigious program gives you a higher chance of working at a prestigious program.

Going to a prestigious program is unlikely to markedly impact your earning potential or get you a good PP job.

 

[Angus Avagadro]

Sorry, insurance pays the same whether you did your residency at Harvard, or Toledo. No offense to Toledo except it is in fly over country. Some of the biggest boobs I ever worked with were from Harvard and Columbia. Getting a personal reference from someone I know has more weight than someones pedigree. Where you did your residency has little to nothing to do with your compensation.

 

[Dr.Bruh]

People who work at larger academic institutions (particularly in high COL cities) almost always make less than their community counter parts. I’m at a large academic center and our attendings (many trained at prestigious places) make literally half of what community ED docs do I used to scribe for or worked with in med school in rural areas. Often went to no name DO schools and community residencies.

 

[ortnakas]

I’m sure there’s groups everywhere in every specialty that cater to a patient list who likes saying how their doctor is a “Harvard graduate.” So maybe this would be an in at certain places, in certain cities.

But the majority of the time, the reverse is true. Training at Big Name Program makes you more likely to go into academia, where you’ll, in fact, make less money, not more.

 

[Lem0nz]

As others have said, if you are applying broadly a big name prestigious program may help you fresh out of fellowship. It is largely irrelevant after you have 1-2 years experience as an attending. It will have zero impact on your pay - the type of job you apply to will dictate your pay. It will give you more options and opportunities for jobs to apply to, but again, if higher compensation is the goal, none of those opportunities opened up by being at a prestigious program will come with a higher paycheck. Quite the opposite. If you want to get paid more money you do not need to be applying to the 'prestigious jobs' available to the 'prestigious applicants'.

Most of the places I applied to were actively looking for non-academic applicants. They pay WAY more than the academic jobs. They require a much broader skillset and level of independence than most academic fellowships will equip a person with fresh out of training.

Keep in mind that many procedural/operative fresh fellows will need anywhere from 1-5 years (or more) of additional mentorship before they are comfortable achieving independent operative skills at the level of complexity necessary to do the well paying jobs - the well paying jobs often have much less support. You're the guy. That's why they're paying you more. Yes you can transfer things but people don't hire you to transfer 20% of your practice, they hire you to take care of the thing and transfer the truly heinous 1% of cases.

 

[sloop]

In psych, fellows dont earn more.

I’m assuming you’re talking about fellowship grads. I think the exceptions to this are child and forensics. Employed child positions often offer higher salaries. Employed forensic positions (generally state hospitals, jails, prisons, etc.) don’t necessarily but the income potential for private forensic work is definitely higher than for private clinical work.

I also think forensics is a bit of an exception where prestige can actually matter. When you testify, you are going to be laying all of your credentials out in front of a judge or jury. Going to a random community place simply will not carry the same weight as a highly regarded academic center. That said, when you’re talking about non-medical people like that, the “prestige” is mostly going to be about whether they’ve heard of the place and the overall reputation of the parent institution rather than the specific residency program.

 

[i-doctor]

No.

Just being honest, but the people from top residency programs tend to be more difficult to work with, so in our small town where everyone knows one another and has to work together, we just don’t get or retain many “top tier” folks.

That said, there is literally a farm down the street from my hospital. High school in one side, farm on the other. So maybe we’re not the type of place ivy leaguers want to go. But year round sunshine and temps in the 60-80’s is nice! If only we weren’t in a drought like the rest of CA. Duluth, MN is looking real good right now…

Yes, Duluth, Traverse City, etc will eventually be the next boom areas. Like Austin and Phoenix are today.

 

[hburgDOC]

My question is, within any given specialty, (say, anesthesiology) would the prestige of residency position translate into future greater income as a practicing physician? Does this change from specialty to specialty?

If the prestige of a residency position does not generally translate into future greater income, what advantages does it confer? I have heard, for instance, the prestige of a residency position matters more when entering academia.

No. I trained at a community hospital, and similarly did an Endocrinology fellowship at a community based hospital system. I now make close to $400k as an Endocrinologist just outside of Philadelphia, at another community based practice. I have counterparts who trained at university systems, and now work there who are making >100k less than I am. If you want to go into academia or research it matters. If you just want to practice and make money, find a program that suits you, learn your stuff and be a good colleague.

 

[i-doctor]

Medicine is unique.
Getting an MBA from a top business school definitely translates to a higher salary.
Getting a law degree from a top law school is now practically mandatory to a high-paying career in law.

But in private practice medicine the prestige of the school and the residency doesn’t matter at all (except perhaps in Beverly Hills and a few coastal enclaves, as mentioned above).

 

[Lawpy]

Why is SDN underestimating the effect of brand names in private practices, especially given the increasing corporatization of medicine? People are still clinging onto the outdated 1990s notion of independent physician practices where no one cares where the attendings went and physicians were all making well north of $400K/year with flexible work schedules

The environment in 2020s is much worse as private equities led by top business school grads start taking over independent practices. And for these guys, nothing makes them more excited than having a Harvard/Stanford/Penn MDs and MD/MBAs on board to help them out with corporate takeovers and raking in many hundreds of millions of dollars.

 

[voxveritatisetlucis]

Why is SDN underestimating the effect of brand names in private practices, especially given the increasing corporatization of medicine? People are still clinging onto the outdated 1990s notion of independent physician practices where no one cares where the attendings went and physicians were all making well north of $400K/year with flexible work schedules

The environment in 2020s is much worse as private equities led by top business school grads start taking over independent practices. And for these guys, nothing makes them more excited than having a Harvard/Stanford/Penn MDs and MD/MBAs on board to help them out with corporate takeovers and raking in many hundreds of millions of dollars.

As somebody who has worked on deals, this isn’t how it works at all. The only thing that PE firms care about are balance sheets, income statements, and statements of cash flows. Yes, they do care a lot about pedigree within their own workers (ie analysts, associates) but this is more to do with the fact that they naturally get along better with these people (both went to Exeter, played lacrosse, etc). when it comes to the businesses they buy, it’s all about cash flow (or innovation). They would prefer the GI doc who went to Caribbean and did an HCA residency raking in 5million in operating cash flow versus the doc who went to Harvard and did residency at BWH but only brings in half the OPCF. If anything, the former is probably easier the give orders/instructions to

If an MD wants to work at one of those firms, then yes pedigree will matter a lot (including undergrad—they like to say so and so went to Yale College and then HMS before doing residency at MGH)

 

[Lawpy]

As somebody who has worked on deals, this isn’t how it works at all. The only thing that PE firms care about are balance sheets, income statements, and statements of cash flows. Yes, they do care a lot about pedigree within their own workers (ie analysts, associates) but this is more to do with the fact that they naturally get along better with these people (both went to Exeter, played lacrosse, etc). when it comes to the businesses they buy, it’s all about cash flow (or innovation). They would prefer the GI doc who went to Caribbean and did an HCA residency raking in 5million in operating cash flow versus the doc who went to Harvard and did residency at BWH but only brings in half the OPCF. If anything, the former is probably easier the give orders/instructions to

If an MD wants to work at one of those firms, then yes pedigree will matter a lot (including undergrad—they like to say so and so went to Yale College and then HMS before doing residency at MGH)

What about being promoted to partner of the equity group? That’s likely to happen coming from a top med school

 

[voxveritatisetlucis]

What about being promoted to partner of the equity group? That’s likely to happen coming from a top med school

They would probably make no new partners, but assuming they did

Maybe if all else equal the Harvard grad would get hired? In the case I mentioned, they would probably still try to retain the Caribbean grad over the Harvard one because by not retaining him, they would be losing the difference in productivity. At least for now, the Caribbean grad could just go to a different group. Why let somebody who brings in more revenue walk away to a competitor?

Aside from cash pay type stuff for wealthy clients, brand isn’t a huge factor in medicine. When one hires a big law firm, they want to see a lot of Harvard and Yale grads. It’s not this way for medicine (yet). The one caveat being is that I could easily see prestige becoming much more important if barriers to entry are lowered (ie. Dramatic expansion of residency spots). Then it may become true that patients would seek out physicians who trained at reputable institutions