5 Years Out Southeast Academic Anesthesiologist - Ask me Anything (AMA)

[IlDestriero]

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The thing is it’s not 5 weeks off. It’s closer to 8 or 9 weeks off. 25 “Official” annual days off

3 “free additional days” (yes that was built in the standard state employee academic job I had)

plus 12 paid sick days

PLUS 10 days cme

plus holidays (comped) if working on those holidays.

you are talking close to 50 days off if u take all the days off. And yes. Many academic docs take at least 7-8 sick days off. At minimum. Dental/doctors/kids appointments.

just do the math.

This is definitely not a universal thing in academics. We don’t have “sick days”. And they track your call outs. And they notice who’s abusing the system. If you call out, someone is losing academic/admin time to cover your shift. Some days the system can absorb that, usually not. Call out a lot and your partners will all hate you.
We don’t have CME days either. Just vacation, and non clinical days per your contract of course.

 

[Justice4all]

If money is the goal, academics is not the place to be. No 100k bonus or 200k. There is annual raise of 2-3% If it’s a fair place and excellent benefits. But if you want to make money go PP and retire to academics

 

[aneftp]

This is definitely not a universal thing in academics. We don’t have “sick days”. And they track your call outs. And they notice who’s abusing the system. If you call out, someone is losing academic/admin time to cover your shift. Some days the system can absorb that, usually not. Call out a lot and your partners will all hate you.
We don’t have CME days either. Just vacation, and non clinical days per your contract of course.

I’m mainly talking about scheduled sick days. Medical dental appointments. It’s near impossible to make those appointments after 3-4pm when you get off work.

you certainly don’t want to waste a post call day at doctors office.

 

[Arch Guillotti]

I’m mainly talking about scheduled sick days.

aka vacation.

 

[vector2]

The thing is it’s not 5 weeks off. It’s closer to 8 or 9 weeks off. 25 “Official” annual days off

3 “free additional days” (yes that was built in the standard state employee academic job I had)

plus 12 paid sick days

PLUS 10 days cme

plus holidays (comped) if working on those holidays.

you are talking close to 50 days off if u take all the days off. And yes. Many academic docs take at least 7-8 sick days off. At minimum. Dental/doctors/kids appointments.

just do the math.

We have a very similar setup. Not to mention instead of q5-6 call we do night float so we have a week of post-call off which can be stacked with bookended vacation/sick/comped holiday time.

 

[IlDestriero]

aka vacation.

Exactly! That’s not a thing at my shop or my last one either. Scheduled sick days are for things like surgery or chemotherapy infusions, emergencies with your kids, etc. Not a dentist appointment and what not. That’s what non clinical, pre/post call, and vacation is for. I can’t imagine the chaos that would ensue if ~100 physicians started calling out a few times a year for trivialities that should be scheduled in non clinical time.

 

[AdmiralChz]

you certainly don’t want to waste a post call day at doctors office.

Then use a pre-call day. Or take vacation. Like this is why you do rotating call!

 

[CUBR]

So in academia, if you dont focus on research, your starting pay is what you'll make forever except for a 50k increase through minor administrative leadership roles/bump to associate prof?

What would a major promotion look like and how hard is that to achieve without research? Say the residency director - is that something you gun at for 20 years with lots of extra work and you get a 100k bonus? Or would it be more like 13 years and a 200k bonus? Or do they just give you more cush academic days and reduce your workload/stress instead?

Is the major source of extra revenue just taking extra call and weekend work instead of striving for the above?

In academics, it's usually time that you're negotiating for. So your salary would stay pretty consistent but more of your FTE would go towards administrative roles including PD or chief of a division, and less towards your clinical responsibilities. Promotions of going from assistant to associate professor, the pay increase is usually relatively small. So, the major source of extra revenue is to take do extra clinical work.

@Zekchar, what's your best advice for a first day junior attending.

 

[Destalchemy]

Ah that makes more sense. So the superstars on UC's public salary database making 600k-1.5 mil - that's all research based then? I was browsing a few institutions anesthesiology teams and some made 300k, some made 5 or 600k. Just trying to get a feel for what that difference is from.

 

[IlDestriero]

Often the Department Chairs have a much higher salary than the remainder of the faculty. Some faculty also have endowed chairs which increase their income. Those are given to stars to retain them. As mentioned above, in academia, non clinical time is usually the most valued thing. There are plenty of bad academic jobs, but if you look at the numbers and how much you’re working, and where you will be in 3,5,10 years, there are plenty of good academic jobs. But only the chair is going to get >90% MGMA money. And they’re doing it for 20% clinical time. Or less. For example senior people only make about 10% more than junior people, the division chief makes about 10% more than the senior people, and the chief makes more than 2x that, however some of that comes from the hospital for other admin responsibilities that they have. So most people are at around the same income but have anywhere from 10-50% non clinical time.
Obviously PP and being your own boss has other benefits, increased freedom, flexibility, more earning potential, different benefits and retirement.
Every job is unique and you have to break it down and see how they fit with your goals.

 

[CUBR]

At certain institutions, the research grant can account for a large percentage of one's salary. However, the grant rarely makes money for the department. Big picture is the young clinical people are making money to pay for the senior people to sit around in their office to do administrative work or research.

Positions like chairman will usually have an endowed professorship attached, which has its own revenue stream that allows that role to have an additional salary.

 

[Zekchar]

So in academia, if you dont focus on research, your starting pay is what you'll make forever except for a 50k increase through minor administrative leadership roles/bump to associate prof?

What would a major promotion look like and how hard is that to achieve without research? Say the residency director - is that something you gun at for 20 years with lots of extra work and you get a 100k bonus? Or would it be more like 13 years and a 200k bonus? Or do they just give you more cush academic days and reduce your workload/stress instead?

Is the major source of extra revenue just taking extra call and weekend work instead of striving for the above?

1) You've pretty much reached your peak salary right off the bat +/- ~50k
2) Payment for administrative promotions tend to be non-clinical days off ... aka 3 days in the OR and 2 days "admin" for residency director. Chairman / Chairwoman usually have some endowment that bumps their salary higher
3) Major source of revenue is picking up extra calls and weekend coverage

 

[Zekchar]

Often the Department Chairs have a much higher salary than the remainder of the faculty. Some faculty also have endowed chairs which increase their income. Those are given to stars to retain them. As mentioned above, in academia, non clinical time is usually the most valued thing. There are plenty of bad academic jobs, but if you look at the numbers and how much you’re working, and where you will be in 3,5,10 years, there are plenty of good academic jobs. But only the chair is going to get >90% MGMA money. And they’re doing it for 20% clinical time. Or less. For example senior people only make about 10% more than junior people, the division chief makes about 10% more than the senior people, and the chief makes more than 2x that, however some of that comes from the hospital for other admin responsibilities that they have. So most people are at around the same income but have anywhere from 10-50% non clinical time.
Obviously PP and being your own boss has other benefits, increased freedom, flexibility, more earning potential, different benefits and retirement.
Every job is unique and you have to break it down and see how they fit with your goals.

Our pay structure is flat and transparent. No benefits given for tenure or seniority. Strictly based on academic standing.
For example:
Every assistant professor make X.
Every associate professor makes X + 25k.
Every full professor makes X + 45k.
Everyone gets the same vacation time, benefits, etc.

 

[Zekchar]

In academics, it's usually time that you're negotiating for. So your salary would stay pretty consistent but more of your FTE would go towards administrative roles including PD or chief of a division, and less towards your clinical responsibilities. Promotions of going from assistant to associate professor, the pay increase is usually relatively small. So, the major source of extra revenue is to take do extra clinical work.

@Zekchar, what's your best advice for a first day junior attending.

Depends on whats important to you. At my gig, there is little financial incentive to do academic work piecemeal ie: 1k for IRB approval, 250 for poster abstract, 2k for book chapter. Those academic projects take a lot of time and you end up doing them during or between cases since you're usually supervising. Cumulatively you have to make your academic CV nice and thick with lots of those things anyways in order to be promoted to the next rank and get a 25k pay bump, so you end up doing it along the way. Some enjoy that work and would do it anyways. Others would rather discuss their boating trips, children's daycare, and car repairs all day long.