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mariposas905 said:
Today, in our pre-health meeting, our advisor talked about how going to a top medical school and residency program nets you a higher salary. Is this true?? I'm personally having a hard time believing it. But if so, then it's worrisome, because I don't know if I have the qualifications to get into a top 20 medical school, or even top 50 🤔

I'm aiming for schools like Rosalind Franklin, VCU, Penn state, etc. I told my advisor this and she asked me what I wanted to be. I don't exactly know yet, but I'm interested in exploring my options in med school. She told me I wouldn't really have a shot at competitive programs, like derm or surgery, going to these schools. She also told me that pediatricians from residency programs like Hopkins get paid more than pediatricians from low-tier MD or DO schools.

WTH? I'm so confused lol would really appreciate if someone could clarify if this is actually real
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People from top-tier medical schools are more likely to go into highly-paid specialties like neurosurgery, plastic surgery, and dermatology. It's definitely not impossible to go into a competitive residency program from a mid-tier medical school, but it's harder. However, I would argue that the average pediatrician from Hopkins makes less than the average pediatrician from a low-tier school. Top medical schools groom their students to strive for academic careers, which, unless you're department chair, pay less than private practice jobs.
 
Maybe they'd heard top schools make it an easier path into competitive specialties or academic positions, and assumed competitive meant better paying?

Edit: Actually nah, if they told you going to penn state meant you could never match general surgery, they're just ignorant/dumb
 
My understanding is that competition can be fierce in academia because funding is not easy to come by/there are few positions, not because it pays better to devote lots of your time to research. It doesn't matter hospital vs their own space somewhere, what I should say is the guys that do nothing but procedures/see patients all day are going to make more than the guys spending lots of their time on research.
 
It also is gonna vary on a person by person basis. If someone gets hired by Jalby's practice because they're Harvard trained and the other guy they were considering isn't, then yeah his prestigious background landed him the high paying job he wanted in a desirable city. Then again, maybe some guy from the VCU class that year is the same specialty and makes even more because he's willing to practice some place that there is no other guy to fight for the spot. You get the idea
 
Academic positions are competitive because they attract people who are interested in becoming leaders (see: research) in their fields. Money isn't the motivator, and at top places like Harvard and Hopkins they know they can offer less money and still get the best. They get funding money, but salary is oftentimes less (unless you run a department). And like Il Destriero mentioned, they don't always have the same types of responsibilities that private care docs, partially due to having fleets of residents and fellows that are insulating them from call and having dedicated research time. Making money in a particular specialty in private practice is generally about work ethic. You can certainly charge more different locations, and the nicer practices in nicer places generally can (as much as insurance will let them). But the degree on the wall is less likely a factor. Also, how freaked out can you get about the money in medicine? Like where are your money goals that are so fragile? I ask because there could always be changes in medicine that could lower reimbursement in a field or in general. I'm not doomsday about medicine at all, but a comfortable living can certainly be had in any specialty from any medical school.
 
All other things being equal, anybody who goes to a better school can choose to make more money or have more opportunities than someone who goes to a lesser name school. There will be less opportunities open to you at a lesser known school than a named school.

With the exception that I think you advisor was talking about certain kinds of surgery and not G-Surg, I agree with everything she said.
 
Where do you think physicians from the top schools and residencies practice after graduation?
Make a list of the states that you think the top earners in medicine work.

Compare your list to this slide:
Medscape Physician Compensation Report 2015

How good was your guess?

Now take a look at a list of physicians at a hospital in a small city in ND. I picked Trinity Hospital in Minot (never been there, don't know anyone there.) You can go in and look at the biographical info for each provider.

Trinity Health - Provider Listing

mariposas905 said:
Academic medicine has this aura of prestige around it; I assumed it was highly paid.
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😆
 
Jalby said:
With the exception that I think you advisor was talking about certain kinds of surgery and not G-Surg, I agree with everything she said.
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Looking at the 2016 match list for Penn State, I see 8 ortho matches? And 5 Derm. You think she was right to say competitive specialties become inaccessible if you go to that kind of school ?
 
mcfruits said:
Is academic medicine actually a sweet gig?

I don't know what to think anymore.
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Physicians in academia are in a strange situation. Virtually none are tenured. Their compensation very much depends on how much clinical income they bring in as measured by RVUs (Relative Value Units -- if you don't know what these are, look it up). They are expected to teach clinical skills and/or give lectures and/or precept small groups of students out of the goodness of their hearts in exchange for the prestige of being at a "teaching hospital" (that would include affiliated outpatient facilities, too). Some will have some of their time "purchased" to free them up for administrative duties such as chairing a committee or serving as a department chair meaning they have to see fewer patients but have to deal with hiring decisions, staffing, budgets and so forth. Some physician-faculty have labs for basic science research and some do clinical research that often involves clinical trials of new treatments for patients. NIH funded research is subject to salary caps so what one earns for the % time devoted to research is not as much as one can make spending those same hours in patient care that carries a high RVU. Clinical trial contracts with Big Pharma usually pay the university for your time and the time of your staff but you make the same salary.

There can be some perks including tuition plans for one's kids but most of the reward is intangible.
 
^ I think it's lower tier.
EDIT: both replies were posted at the same time, my bad
 
mwsapphire said:
^ I think it's lower tier.
EDIT: both replies were posted at the same time, my bad
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I spent some time there and I think it's a great school. The professors are great, they have an excellent clinical simulation center (I work at one, so I'm partial to schools with these), and the students are very friendly. I wouldn't write it off so easily.
 
Endoxifen said:
I spent some time there and I think it's a great school. The professors are great, they have an excellent clinical simulation center (I work at one, so I'm partial to schools with these), and the students are very friendly. I wouldn't write it off so easily.
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I never said there was anything wrong with a lower tier school, I just meant int terms of ranking it's lower.
So is my state school, it's lower tier in MA, and I'm happy here.
Low tier Does not equal bad.
 
OP, doctors are paid so well anyway, I really don't see why people freak out over salary differences at a higher-tier-school.
Docs already out-earn everyone else?
 
In academia, you're often trading money for some increased lifestyle. Though everyone's research commitment is unique and that can definitely take a lot of your free time.
I'm not driven by maximizing income, if I was, I'd be in private practice working 60+ hours a week, taking 50+ calls a year, covering 3-4 rooms at a time, etc. Instead I work less than 50 hours a week, take about 15 calls a year, cover 1-2 ORs at a time, etc.
If you find a good academic job, you might even get paid pretty fairly, but like anything, some are 90th percentile income and some are 25th. As Lizzy noted above, a lot of that comes down to how much you're actually working with patients and how many units you can generate. A couple of well known places pay much lower than my shop, but they also work significantly fewer clinical days. You have to figure out what works for you.


--
Il Destriero
 
random sort of related question - who are the 1% of physicians? People that invent/patent a new device or drug that becomes widespread? People that move up the chain to the top of administrating a giant hospital system?
 
@IlDestriero How profitable are urgent care centers? Grow out the center as an employee to start initial funding into the business and then build it out by staffing it with PA's and other mid levels. If profitable, then pivot into another urgent care center in another urban or suburban area. If not profitable, then close shop and start saving again.
 
efle said:
random sort of related question - who are the 1% of physicians? People that invent/patent a new device or drug that becomes widespread? People that move up the chain to the top of administrating a giant hospital system?
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I've heard through the grapevine that the highest paid doc at my academic institution runs a solely cash based (no insurance) derm practice to help the rich look pretty. He does a little self-funded research on the side -- mostly to obtain evidence that one approved treatment is better than another.

Most top hospital administrators are business people, not physicians.

Many of the drug developers are PhDs in the lab, not physicians.
 
Sardinia said:
@IlDestriero How profitable are urgent care centers? Grow out the center as an employee to start initial funding into the business and then build it out by staffing it with PA's and other mid levels. If profitable, then pivot into another urgent care center in another urban or suburban area. If not profitable, then close shop and start saving again.
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Probably a better question for the EM forum, but if they weren't profitable, there wouldn't be 5 or 6 within a few miles of my house. Of course I live in the wealthy suburbs where most are insured. A Medicaid practice in the inner city probably wouldn't be profitable. If they're attached to CVS, etc. it's probably to increase sales in the store.


--
Il Destriero
 
efle said:
Ehh lower end of middle I guess, same with Rosalind. I looked it up cuz OP mentioned it in particular not because I think it's a bad school
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What makes you call Rosalind "lower end of middle"? Just curious since I was under the impression it is very much lower tier for a US MD school. Not saying it's "bad" (it is where I will most likely be going) but if you are ranking them, not sure how many schools fall below Rosalind's "prestige."

For the OP, it is completely ridiculous for you to be worrying about ultimate career outcomes of top tier med students vs lower tier med students. If you get into a US MD school, the opportunity is there for you to accomplish basically whatever you want in medicine. Do top tier med students have a better set up to have more opportunities? Sure, the same way a top tier undergrad gives a leg up for people. But doors certainly aren't CLOSED to you just because your med school isn't a big name. I don't know how premed advisers can be so off base...

Also, why would the fact that physicians from a top 20 program make more $ (if it were true) freak you out? "boohoo, I only make 275k per year while that harvard med grad makes 300k." Relax. Focus on doing your best and getting into a med school.
 
partypantss said:
What makes you call Rosalind "lower end of middle"? Just curious since I was under the impression it is very much lower tier for a US MD school. Not saying it's "bad" (it is where I will most likely be going) but if you are ranking them, not sure how many schools fall below Rosalind's "prestige."

For the OP, it is completely ridiculous for you to be worrying about ultimate career outcomes of top tier med students vs lower tier med students. If you get into a US MD school, the opportunity is there for you to accomplish basically whatever you want in medicine. Do top tier med students have a better set up to have more opportunities? Sure, the same way a top tier undergrad gives a leg up for people. But doors certainly aren't CLOSED to you just because your med school isn't a big name. I don't know how premed advisers can be so off base...

Also, why would the fact that physicians from a top 20 program make more $ (if it were true) freak you out? "boohoo, I only make 275k per year while that harvard med grad makes 300k." Relax. Focus on doing your best and getting into a med school.
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My personal breakdown of upper/mid/lower is this kind of thing, where lower means brand new programs or mission based programs where the pool of applicants is not really the overall pool, it's some tiny subset that fit their desired background/interests. If you just line up all med schools by reputation and break into thirds then yeah it's lowest third, but that's now how I think of this topic
 
efle said:
Looking at the 2016 match list for Penn State, I see 8 ortho matches? And 5 Derm. You think she was right to say competitive specialties become inaccessible if you go to that kind of school ?
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Are we really going to say that a better school would not have a better match list???

Anybody can go to any school and get any residency if they are amazing. It is easier to fall from a better school into a decent residency than to do the opposite.

So yes, if you end up in a low teir school the cards are stacked against you for getting a very good residency spot. It doesn't mean it cannot be done, but it does mean it isn't as likely
 
Jalby said:
Are we really going to say that a better school would not have a better match list???

Anybody can go to any school and get any residency if they are amazing. It is easier to fall from a better school into a decent residency than to do the opposite.

So yes, if you end up in a low teir school the cards are stacked against you for getting a very good residency spot. It doesn't mean it cannot be done, but it does mean it isn't as likely
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Dude what? I never said anything about comparing that match list to another school?

Advisor says going to penn state means no real shot at competitive specialties. You pointed out her G-surg example was a mistake and she must have meant competitive surgical specialties, but that you agree. Yet penn state sent 8 ppl into freakin' ortho.

Obviously if I'm aiming for ortho I'd rather go to U Penn than Penn State but that's not the topic. Saying penn state -> no real shot at ortho is just obvs bad advising
 
For Penn State , I count 23 people going into competitive residencies out of 130 applicants. So the top 17% get into competitive residencies.
Rosalind Franklin has 15 out of 194 people, so the top 7%.
VCU had 15 out of 170 people, so top top 9%.

I actually would not have put Penn state in the same category as the other two. I put Penn State at about the 70th best school and the others in the bottom 20. Regardless, chances are quite limited at those schools.

https://s3.amazonaws.com/rfums-bigtree/files/resources/cms-match-list-2017.pdf
 
This is a not a thing (within the same specialty). Most of the recruiters for attending jobs are looking for a warm body with a pulse (who is board certified w/ a cleanish record). Imagine the exact opposite of med school admission. They are desperate, you have a million choices (in most markets).

I knew the salary before sending in my CV. This might be very different in the academic world. But in private practice nobody cares.
 
link2swim06 said:
This is a not a thing (within the same specialty). Most of the recruiters for attending jobs are looking for a warm body with a pulse (who is board certified w/ a cleanish record). Imagine the exact opposite of med school admission. They are desperate, you have a million choices (in most markets).

I knew the salary before sending in my CV. This might be very different in the academic world. But in private practice nobody cares.
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Are you posting in the wrong thread? Great jobs are very competitive in any field. Any schmuck can get a job someplace, but if you are gunning for a great job in a desirable city with real competition, it's a sellers market. Though where you did your residency is far more important than where you went to school. Great jobs don't need recruiters, they don't even post them anywhere. They have people lining up to give them their CV and can recruit superior candidates from their own network.


--
Il Destriero
 
mariposas905 said:
Today, in our pre-health meeting, our advisor talked about how going to a top medical school and residency program nets you a higher salary. Is this true?? I'm personally having a hard time believing it. But if so, then it's worrisome, because I don't know if I have the qualifications to get into a top 20 medical school, or even top 50 🤔

I'm aiming for schools like Rosalind Franklin, VCU, Penn state, etc. I told my advisor this and she asked me what I wanted to be. I don't exactly know yet, but I'm interested in exploring my options in med school. She told me I wouldn't really have a shot at competitive programs, like derm or surgery, going to these schools. She also told me that pediatricians from residency programs like Hopkins get paid more than pediatricians from low-tier MD or DO schools.

WTH? I'm so confused lol would really appreciate if someone could clarify if this is actually real
Click to expand...


Ok, first of all, you have got to get rid of this tiered idea of medical schools. Yeah Harvard is Harvard, and Johns Hopkins is Johns Hopkins, but it really doesn't matter that much.

Second. Pre-med advisors are some of the worse people to give advice, they just never know what the hell they are talking about.

Third, Where you went to school means exactly nothing toward how much money you make. The speciality you choose has got to be about what you enjoy doing, because trust me, you are going to be doing A LOT of it. So you pick your field based on what you like. Reimbursement is always changing, specialities that make lots of money can switch in a matter of years, just look at radiology, once the pillar of the ROAD specialites, many programs scramble now because the market is so poor.

At your phase, just study for the MCAT, do some extracurriculars that make you seem like a cool person in some way, drink lots of beer, enjoy life. Any medical school admission is a huge accomplishment, don't worry about which school you go to, and defenitly NEVER go see that advisor again, because they are steering you wrong
 
It seems like as long as u get s competitive step and take a year off for research, you won't have any trouble getting to a competitive specialty residency coming from any us md school

And if u wanna make a bunch of money, just work in areas where salaries are higher.
 
So?

mariposas905 said:
Today, in our pre-health meeting, our advisor talked about how going to a top medical school and residency program nets you a higher salary. Is this true?? I'm personally having a hard time believing it. But if so, then it's worrisome, because I don't know if I have the qualifications to get into a top 20 medical school, or even top 50 🤔

I'm aiming for schools like Rosalind Franklin, VCU, Penn state, etc. I told my advisor this and she asked me what I wanted to be. I don't exactly know yet, but I'm interested in exploring my options in med school. She told me I wouldn't really have a shot at competitive programs, like derm or surgery, going to these schools. She also told me that pediatricians from residency programs like Hopkins get paid more than pediatricians from low-tier MD or DO schools.

WTH? I'm so confused lol would really appreciate if someone could clarify if this is actually real
Click to expand...
 
IlDestriero said:
Are you posting in the wrong thread? Great jobs are very competitive in any field. Any schmuck can get a job someplace, but if you are gunning for a great job in a desirable city with real competition, it's a sellers market. Though where you did your residency is far more important than where you went to school. Great jobs don't need recruiters, they don't even post them anywhere. They have people lining up to give them their CV and can recruit superior candidates from their own network.
--
Il Destriero
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In my specialty there are only a few markets that are competitive (non-academic). Although I guess this doesn't say much about the job search in other specialties.

Certainly there are plenty of unlisted jobs...but even the vast majority of these places seem to be actively hiring.
 
Just wanted to point out that someone matching in a "non-competitive" specialty does not necessarily mean they were not a strong applicant for competitive specialties. Whenever I look at match lists, I don't just look at the speciality, I look at the program. Internal medicine isn't generally considered competitive, but you have to be extremely competitive to match IM at Hopkins, MGH, Mayo, UCSF, and other top IM programs. A lot of people seem to forget that there are very competitive students, who score high on Step, who actually go into less competitive specialties by choice. For example I know someone who got a 260 on Step 1 and is going into Psych because she loves it and that's what she has always wanted to do.
 
thenucleusaccumbens said:
Just wanted to point out that someone matching in a "non-competitive" specialty does not necessarily mean they were not a strong applicant for competitive specialties. Whenever I look at match lists, I don't just look at the speciality, I look at the program. Internal medicine isn't generally considered competitive, but you have to be extremely competitive to match IM at Hopkins, MGH, Mayo, UCSF, and other top IM programs. A lot of people seem to forget that there are very competitive students, who score high on Step, who actually go into less competitive specialties by choice. For example I know someone who got a 260 on Step 1 and is going into Psych because she loves it and that's what she has always wanted to do.
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Oh my god.
Thank you!
Success in medicine isnt measured by how competitive your specialty is, but how much you love it and are good at it.
 
mariposas905 said:
Today, in our pre-health meeting, our advisor talked about how going to a top medical school and residency program nets you a higher salary. Is this true?? I'm personally having a hard time believing it. But if so, then it's worrisome, because I don't know if I have the qualifications to get into a top 20 medical school, or even top 50 🤔

I'm aiming for schools like Rosalind Franklin, VCU, Penn state, etc. I told my advisor this and she asked me what I wanted to be. I don't exactly know yet, but I'm interested in exploring my options in med school. She told me I wouldn't really have a shot at competitive programs, like derm or surgery, going to these schools. She also told me that pediatricians from residency programs like Hopkins get paid more than pediatricians from low-tier MD or DO schools.

WTH? I'm so confused lol would really appreciate if someone could clarify if this is actually real
Click to expand...

I'm going to give you a simplified explanation to a fairly complex situation, but the upshot is that your medical school does not determine your future pay. Let's say you want to be a pediatrician. You go to med school, do a pediatrics residency, and then take a job doing general peds. To get patients and get paid you will sign contracts with insurers who cover the area, and those contracts will stipulate how much you get reimbursed for the different services you provide.

The insurers themselves DGAF where you went to school. If you are licensed to practice medicine and credentialed to provide pediatric services then you will get paid something close to the prevailing (customary) rate for the area.

Part of the reason this holds true is that there is pent up demand for many medical specialties in most parts of the country. If you are a pediatrician, internist, family medicine doc, OB/GYN, general surgeon, etc., you can go practically anywhere and find a job. Go somewhere, get licensed, get plugged in, see patients, earn a living.

There are some fields, however, where it's more complicated. Two of the big ones are pathology and diagnostic radiology. Again, I am simplifying things, but those fields depend not so much on inborn patient demand to function. Instead they have to woo other providers to send them business. My understanding is the pathology job market has sucked for years, and radiology has swung from low to high and back again. In those situations it makes some sense that your pedigree is worth something, and that training at top name institutions can benefit your career by virtue of networking.

Other situations exist, of course. If you happen to be a highly specialized surgeon doing some rare procedure then the normal rules do not apply.

So, like I said, it's complex. In the end I would say your advisor generally does not know what she is talking about, but she has unwittingly illuminated a kernel of truth, buried in a riddle, wrapped around an enigma, and fried up in a conundrum with Chinese dipping sauce.
 
I like to think of the acronym DOONE ( Derm/Opthal/Orthopods/Neurosurg/ENT) to replace ROAD for the uber specialties.

HooliganSnail said:
Ok, first of all, you have got to get rid of this tiered idea of medical schools. Yeah Harvard is Harvard, and Johns Hopkins is Johns Hopkins, but it really doesn't matter that much.

Second. Pre-med advisors are some of the worse people to give advice, they just never know what the hell they are talking about.

Third, Where you went to school means exactly nothing toward how much money you make. The speciality you choose has got to be about what you enjoy doing, because trust me, you are going to be doing A LOT of it. So you pick your field based on what you like. Reimbursement is always changing, specialities that make lots of money can switch in a matter of years, just look at radiology, once the pillar of the ROAD specialites, many programs scramble now because the market is so poor.

At your phase, just study for the MCAT, do some extracurriculars that make you seem like a cool person in some way, drink lots of beer, enjoy life. Any medical school admission is a huge accomplishment, don't worry about which school you go to, and defenitly NEVER go see that advisor again, because they are steering you wrong
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^ It's also weird to me that IM gets treated as one big blob, never see mention of Cardio or Gastro in threads about what is competitive
 
Goro said:
I like to think of the acronym DOONE ( Derm/Opthal/Orthopods/Neurosurg/ENT) to replace ROAD for the uber specialties.
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I don't know Goro. I see that as "DO ONE" rather than "DOONE." :whistle:
 
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