A good amount of FMGs in cardio fellowships

[acesup123]

I've been checking out some random cardiology residency websites and I noticed a lot of them have a fair amount of FMGs, especially from India. Some of them are over 50% FMG. Nothing against FMGs but I thought that cardiology fellowships were super competitive. These hospitals aren't in big cities like Chicago or LA, but I still figured that even in smaller cities they would be filled with American grads. I mean I would live in a small midwestern city for 3 years to make 300k or more after fellowship.

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[josephf1]

as cardio salries come down adn they are, no one wants to do it anymore among us grads. this is true now for all im specialties. us grads are going for surgical subscepialties or not going in to medicine at all. it is becoming impossible to compete with foriegn grads with no student debt. for a us grad to take on 300k in debt to make 300k or less after 15 years of training is not attractive or for many even finacially feasable. the good old days of cardiology and its legend as supercompetitive is over. all interviewees at our program the last few years are fmgs from south america or india.

 

[bronx43]

as cardio salries come down adn they are, no one wants to do it anymore among us grads. this is true now for all im specialties. us grads are going for surgical subscepialties or not going in to medicine at all. it is becoming impossible to compete with foriegn grads with no student debt. for a us grad to take on 300k in debt to make 300k or less after 15 years of training is not attractive or for many even finacially feasable. the good old days of cardiology and its legend as supercompetitive is over. all interviewees at our program the last few years are fmgs from south america or india.

I assure you this above post is entirely inaccurate. First off, while it's true that cardiology reimbursements aren't exactly going up, it's laughable to think that US graduates don't want to go into it. It is still by far the most competitive (along with GI) internal medicine subspecialty. And the idea that US grads are shunning IM is false, as well. Last year was one of the most competitive years for IM in general, as the vast majority of programs I interviewed at stated they had record number of applicants. There was also a record low number of post-match open spots in the country. And I agree that surgical subspecialties are still some of the most competitive fields, but I have not seen a salary survey out there that shows cardiology with substantially lower numbers than ENT, urology, ophto, etc. Cardiology compensation is AT LEAST on par with those aforementioned fields, with EP and interventional surpassing them.
If you look at fellowship programs at large academic center (not small community-based fellowships), you'll see that the vast majority are US grads from very respectable IM programs. The reason why there are any IMGs at all is due to research, which plays a big part in the application process. If you published at all, you can make yourself very competitive. At my institution, which is a large academic medical center, all of our cards fellows are from big name top 30 residency programs. We had a few FMGs graduate from years past, but they had longer lists of published papers than most of our attendings.

 

[josephf1]

i would disagree, your facts are dated
I am in a major city in the SE looking for jobs and getting around 250-280K offers. The NE is even worse. Yes, you can make 500K, in Arkansas, Iowa, etc. I don't want to live there.
EP is starting around 300K. Not more. And jobs are few.
Academic medicine is really bad, I have friends with advanced fellowships at major Universitys making 250 as well.
Now keep in mind for every 10,000 you borrow in student loans you pat back 100 a month on a 15 year repayment plan. 100K loans = 1000 a month. 300K loans = 300 a month.
You make 250K and Obama takes 40% and state tax another 10% you are looking at $10000 a month after taxes. Pay 3K i nstudent loans, and you are living on 7K a month. I make 4K a month now a fellow. Whats another 3K a month? A mortage payment. 2 kids in private school. 2 BMWs with car insurance and gas. A country club memebership. That's it. Pick one of the above. You aint getting more. Your Indian friends will have a better house. Kids in private schools. etc etc. Dont be niave. You are seeing unsophisticated med heads with no financial savvy training themselves into being highly taxed working poor. And wait till they have to put their kids through college.

 

[bronx43]

i would disagree, your facts are dated
I am in a major city in the SE looking for jobs and getting around 250-280K offers. The NE is even worse. Yes, you can make 500K, in Arkansas, Iowa, etc. I don't want to live there.
EP is starting around 300K. Not more. And jobs are few.
Academic medicine is really bad, I have friends with advanced fellowships at major Universitys making 250 as well.
Now keep in mind for every 10,000 you borrow in student loans you pat back 100 a month on a 15 year repayment plan. 100K loans = 1000 a month. 300K loans = 300 a month.
You make 250K and Obama takes 40% and state tax another 10% you are looking at $10000 a month after taxes. Pay 3K i nstudent loans, and you are living on 7K a month. I make 4K a month now a fellow. Whats another 3K a month? A mortage payment. 2 kids in private school. 2 BMWs with car insurance and gas. A country club memebership. That's it. Pick one of the above. You aint getting more. Your Indian friends will have a better house. Kids in private schools. etc etc. Dont be niave. You are seeing unsophisticated med heads with no financial savvy training themselves into being highly taxed working poor. And wait till they have to put their kids through college.

Wait, do you actually think ENT, ophtho, anesthesiologists are coming out making 350-400k in big cities? Starting salaries even for high paying fields are not astronomical. In fact, my ophtho buddies who are looking for jobs right now are getting offers <200k in big cities. The urology residents I know are getting 250-300k in medium to large cities. However, that doesn't mean that their mid-career salaries will remain at those amounts. The cards attendings at my institution who are 7-10 years out of fellowship are pulling 300-350k for general cards and 450k for interventional. I can assure you they didn't start out with those numbers.
But, throwing this money exercise aside, it's entirely false that cardiology is not a competitive subspecialty or that IM is getting less competitive.
And as far as reimbursement cuts for cardiology, just keep in mind that this isn't a problem exclusive to cardiology. Cuts are happening across the board, and will only deepen as we move further into debt. There's really no escaping this problem in any field of medicine, and will ultimately not affect cardiology competitiveness with respect to other specialties.

 

[DrVanNostran]

Wait, do you actually think ENT, ophtho, anesthesiologists are coming out making 350-400k in big cities? Starting salaries even for high paying fields are not astronomical. In fact, my ophtho buddies who are looking for jobs right now are getting offers <200k in big cities. The urology residents I know are getting 250-300k in medium to large cities. However, that doesn't mean that their mid-career salaries will remain at those amounts. The cards attendings at my institution who are 7-10 years out of fellowship are pulling 300-350k for general cards and 450k for interventional. I can assure you they didn't start out with those numbers.
But, throwing this money exercise aside, it's entirely false that cardiology is not a competitive subspecialty or that IM is getting less competitive.
And as far as reimbursement cuts for cardiology, just keep in mind that this isn't a problem exclusive to cardiology. Cuts are happening across the board, and will only deepen as we move further into debt. There's really no escaping this problem in any field of medicine, and will ultimately not affect cardiology competitiveness with respect to other specialties.

I'm not quite sure where the other poster is getting his info, but I am in complete agreement with Bronx. I can echo what you are saying from what I am hearing from my friends. Starting salaries in any specialty are that great in comparison to the 5-10 year salary.

Obviously anyone with no debt will be better off. But 250-300 for medicine sub-specialties (i.e. cards, go h/o) is pretty good. A lot of ophto, uro folks start in the same range, but they probably have a higher ceiling.

Also, 10% state tax is not true for every state.

 

[EPADHA]

A reason that is often quoted by my colleagues from India is that cardiovascular disease is so common in India that almost all of them have been touched deeply in some way by CVD. Moreover, they also tell me that it's among the most respected specialities in India. So given the epidemic that's unfolding in South Asia and the reputation and money associated with cardiology, they tend to gravitate towards doing fellowships in CVD.

 

[bronx43]

A reason that is often quoted by my colleagues from India is that cardiovascular disease is so common in India that almost all of them have been touched deeply in some way by CVD. Moreover, they also tell me that it's among the most respected specialities in India. So given the epidemic that's unfolding in South Asia and the reputation and money associated with cardiology, they tend to gravitate towards doing fellowships in CVD.

The OP's question wasn't why FMGs from India try to go into cardiology. There isn't a shortage of reasons for them (and a lot of other people) to go into cardiology. The question is why American fellowships would take them over American grads.

 

[josephf1]

i think you are all missing the point
ya a few elite institutions in prime locations will get all us grads
but even elite institutions in less desireable places get only fmgs
look at midwestern programs and up by wisconsin/michigan etc
beleive me if it was SO desirable like plastics or derm, there would be NO IMGs
the fact that cardiology is 50% IMGS again only shows the legacy about its cache is still big in the eyes of foreigners or to them perhaps 300K is a lot of money. Its not. You can make that in IM/hospitalist as well. The fact is with all the reimbursement cuts cardio doesnt earn big $$$ now with few exceptions so the competitiveness is down.
The old timers want out. I get emails every day about unfilled EP andother advnaced fellowships begging for fellows. No body even wants to do them any more. There is too much oversaturation in the nice places to live and competition has also driven down income. You can hoo haa all day about pubs and research and harvard and blah blah blah but no normal human will do a call intensive specialty like cardio unless you pay them 500K, once the income comes down to 7 on 7 off levels forget it. Only foregniers trying to stay on visa or outtrain the US grads to prove themselves will do it. As you see is already happening.

 

[DrAwsome]

i think you are all missing the point
ya a few elite institutions in prime locations will get all us grads
but even elite institutions in less desireable places get only fmgs
look at midwestern programs and up by wisconsin/michigan etc
beleive me if it was SO desirable like plastics or derm, there would be NO IMGs
the fact that cardiology is 50% IMGS again only shows the legacy about its cache is still big in the eyes of foreigners or to them perhaps 300K is a lot of money. Its not. You can make that in IM/hospitalist as well. The fact is with all the reimbursement cuts cardio doesnt earn big $$$ now with few exceptions so the competitiveness is down.
The old timers want out. I get emails every day about unfilled EP andother advnaced fellowships begging for fellows. No body even wants to do them any more. There is too much oversaturation in the nice places to live and competition has also driven down income. You can hoo haa all day about pubs and research and harvard and blah blah blah but no normal human will do a call intensive specialty like cardio unless you pay them 500K, once the income comes down to 7 on 7 off levels forget it. Only foregniers trying to stay on visa or outtrain the US grads to prove themselves will do it. As you see is already happening.

I agree with you to some extent that cards has indeed become less competitive over the years and that pay has indeed gone down. It's not in the dumps, but it's not unreasonable to see grads start in the 300k range which kind sucks. And sure you can get a 300k hospitalist gig these days because of the huge demand, but is that going to last? Who knows. Many EM's also can make that kind of money these days. A lot of the specialties once thought to be big money makers are taking a big hit. GI I'd say is still pretty up there financially speaking but I heard it's incredibly competitive. We'll see what happens with Obamacare and this whole healthcare reform. I do believe things will rebound, but it may take a while. There is a large shortage of doctors overall, predicted to be about 91,000 by 2020. If salaries keep plummeting that will become even worse.

 

[acesup123]

So is a US grad with little to no research likely to get picked over an FMG with tons of research, assuming equal board scores etc...

 

[infarct]

So is a US grad with little to no research likely to get picked over an FMG with tons of research, assuming equal board scores etc...

yes...even w lower board scores.

 

[DrVanNostran]

300K as a hospitalist...trust me thats not easy to find and they are not in great spots. 160-180 is about what you see in major cities in the private setting. Cards offers are from 250-300, with a high income potential. So what if there are about 40% FMGs in cards? Its still competitive and people who feel they are competitive apply. US IM residents flock to all different specialties because of where thier interest lies. Derm/Plastics are obviously more competitive, but remember we are talking out of medical school, which is pretty much based on Step 1/AOA. Fellowship competitiveness has a different set of rules. You can't compare the two.

 

[HarryGary]

Just speaking generally, but on the interview trail this year I saw 2 FMG applicants -- and one of them had his own K award. This is not a reality at just about all university programs.

 

[hotshotdoc]

You guys are making it too complicated,
How are you going to see a lot of american medical grads (AMGs) in cardiology if they do not take up IM residency after med school?
Most of med students (that i have interacted with) want to do surgical or allied specialities, they call themselves "doers/hands on people" and not the ones who like to "sit in the clinic and think about pathophysiology". Once in a while i would meet an AMG who would be genuinely interested in cardiology or GI and would want to do IM. No wonder medicine programs dont find AMGs and have to find IMGs to fill up.

 

[NightDoctor]

I really loved cardiology as a med student and as a preliminary internal medicine intern - I was bored and fell into this forum. I am an ophthalmology resident currently. I think cardiology would be one of the most competitive fields if you didn't have to complete 3 years of internal medicine to do it. As far as I can tell, there is no need to do more than a rigorous medicine intern year prior to cardiology specialty training. A lot of the last two years of medicine residency are spent doing irrelevant (to cardiology) consults and outpatient clinics which would not make one a greater cardiologist. That two year difference is important and certainly was somewhat a factor in my specialty choice. The ACC (or whomever) should rethink the requirements for cardiology fellowship.

 

[joshmir]

It may be that there are financial penalties (ie the amount the govt/CMS pays to the hospital to subsidize each resident) to residencies that take FMG residents (I know for a fact that AMGs result in full funding, FMGs result in less funding), but those penalties are not there for taking FMG fellows; in fact I'm confident this is the case

It may be that this financial advantage is what makes it harder for FMGs in residnecy; if this playing field were leveled we AMGs may not do as well in residencies as we do now

 

[infarct]

I really loved cardiology as a med student and as a preliminary internal medicine intern - I was bored and fell into this forum. I am an ophthalmology resident currently. I think cardiology would be one of the most competitive fields if you didn't have to complete 3 years of internal medicine to do it. As far as I can tell, there is no need to do more than a rigorous medicine intern year prior to cardiology specialty training. A lot of the last two years of medicine residency are spent doing irrelevant (to cardiology) consults and outpatient clinics which would not make one a greater cardiologist. That two year difference is important and certainly was somewhat a factor in my specialty choice. The ACC (or whomever) should rethink the requirements for cardiology fellowship.

you can say this of a lot of fields

 

[bronx43]

It may be that there are financial penalties (ie the amount the govt/CMS pays to the hospital to subsidize each resident) to residencies that take FMG residents (I know for a fact that AMGs result in full funding, FMGs result in less funding), but those penalties are not there for taking FMG fellows; in fact I'm confident this is the case

It may be that this financial advantage is what makes it harder for FMGs in residnecy; if this playing field were leveled we AMGs may not do as well in residencies as we do now

Or, it can simply be that American program directors prefer American grads for a variety of reasons including lack of cultural barrier and recognition of residency/medical school. Top IM residencies do the same, and it trickles up to the fellowship level.

 

[dragonfly99]

cardiology (general) does not start at 300k in a lot of areas now...but the salary is still pretty good. I think cardiology is less competitive in recent yrs for a number of reasons. One reason is they actually opened up a few more cards fellowship spots, so more spots for a few more people. Also, hospitalist gig is looking better to a lot of people recently, so some ppl bailed to do that. After 3 yrs IM residency, some ppl just get tired and realize they don't want to do 3-5 years more training. I have seen a few ppl bail and change plans to pulmonary/critical care also. Some ppl see big reimbursement cuts coming to cardio, but that remains to be seen...
GI I am pretty sure is more competitive than cardio...partly due to a smaller # of spots I'm pretty sure. Most GI fellowships only have about 3 fellows, right?

 

[bronx43]

cardiology (general) does not start at 300k in a lot of areas now...but the salary is still pretty good. I think cardiology is less competitive in recent yrs for a number of reasons. One reason is they actually opened up a few more cards fellowship spots, so more spots for a few more people. Also, hospitalist gig is looking better to a lot of people recently, so some ppl bailed to do that. After 3 yrs IM residency, some ppl just get tired and realize they don't want to do 3-5 years more training. I have seen a few ppl bail and change plans to pulmonary/critical care also. Some ppl see big reimbursement cuts coming to cardio, but that remains to be seen...
GI I am pretty sure is more competitive than cardio...partly due to a smaller # of spots I'm pretty sure. Most GI fellowships only have about 3 fellows, right?

By a lot of areas, do you mean like NYC, LA, Boston, Chi? Also, are these academic positions or private?

 

[thierryhenry]

300K as a hospitalist...trust me thats not easy to find and they are not in great spots. 160-180 is about what you see in major cities in the private setting. Cards offers are from 250-300, with a high income potential. So what if there are about 40% FMGs in cards? Its still competitive and people who feel they are competitive apply. US IM residents flock to all different specialties because of where thier interest lies. Derm/Plastics are obviously more competitive, but remember we are talking out of medical school, which is pretty much based on Step 1/AOA. Fellowship competitiveness has a different set of rules. You can't compare the two.

Hospitalist in SE Ohio is 240K+ plus bonuses coming straight out of residency
So yes it depends on location, but I think that number is floating around now in the midwest and 300K in places like Kansas and other areas

 

[ukdoc74]

When I got into IM, I though I wanted to do Cards. I realized like most people that in this era of accountable care, that salaries are equalizing. It is better to pick a lifestyle field that pays pretty good.

That's why I chose heme/onc.

The problem is that there are only 400+ heme onc spots compared to 800+ cardiology spots.

Dragonfly is right. In the last 3 years, there has been a 30-40% increase in cardiology spots. This will further saturate the job market.

That is why Cardiology is no longer #2 in competitiveness.

GI and Heme/Onc have much fewer spots so are more competitive than Cardiology.

 

[ukdoc74]

I'm not quite sure where the other poster is getting his info, but I am in complete agreement with Bronx. I can echo what you are saying from what I am hearing from my friends. Starting salaries in any specialty are that great in comparison to the 5-10 year salary.

Obviously anyone with no debt will be better off. But 250-300 for medicine sub-specialties (i.e. cards, go h/o) is pretty good. A lot of ophto, uro folks start in the same range, but they probably have a higher ceiling.

Also, 10% state tax is not true for every state.

Agree with Urology but Optho is overrated. I know two people that switched out of optho. One switched into ER and other to internal medicine.

They are an outpatient based field and starting salaries are less than $200k. Plus, look at the number of optho residents having to do a fellowship.

 

[Eurostar]

When I got into IM, I though I wanted to do Cards. I realized like most people that in this era of accountable care, that salaries are equalizing. It is better to pick a lifestyle field that pays pretty good.

That's why I chose heme/onc.

The problem is that there are only 400+ heme onc spots compared to 800+ cardiology spots.

Dragonfly is right. In the last 3 years, there has been a 30-40% increase in cardiology spots. This will further saturate the job market.

That is why Cardiology is no longer #2 in competitiveness.

GI and Heme/Onc have much fewer spots so are more competitive than Cardiology.

The number of spots has nothing to do with competitiveness. So you're saying Allergy and Sleep medicine is more competitive than Cards and GI? It has to do with the number of people applying to those spots and the quality of those people. Cardiology is still the most competitive due to that fact. Why do you think most of the people coming out of Mass Gen, Brigham, Columbia, etc are going into cardiology? You need more research, better scores and letters from bigger name people to match in Cardiology. GI is a close second and may be equivalent to cardiology at this point. Clearly, Heme/Onc at MD Anderson or Dana Farber is super competitive, but overall cards and GI are well above the rest as far as overall competitiveness.

 

[DrAwsome]

cardiology (general) does not start at 300k in a lot of areas now...but the salary is still pretty good. I think cardiology is less competitive in recent yrs for a number of reasons. One reason is they actually opened up a few more cards fellowship spots, so more spots for a few more people. Also, hospitalist gig is looking better to a lot of people recently, so some ppl bailed to do that. After 3 yrs IM residency, some ppl just get tired and realize they don't want to do 3-5 years more training. I have seen a few ppl bail and change plans to pulmonary/critical care also. Some ppl see big reimbursement cuts coming to cardio, but that remains to be seen...
GI I am pretty sure is more competitive than cardio...partly due to a smaller # of spots I'm pretty sure. Most GI fellowships only have about 3 fellows, right?

Out of curiosity, what type of salaries does cards start at now? I thought it paid quite well in the past, although I have heard that there were some cuts.

But you are absolutely right about the whole thing about hospitalist jobs being very popular these days. Where I did internship, most of the IM grads did go into hospitalist jobs. In the midwest where I'm at, it's not hard to find 300k hospitalist jobs. I get emails almost daily about needs, and the salaries are not bad, plus bonuses, some have flexible scheduling etc.

I guess you really have to think about doing an additional 3 years if you won't make that much more and are ok with being a hospitalist. Although initially the whole 26 weeks off might sound nice, I am not sure if I could work 7 days straight for 12 hours a day. That's brutal!

 

[ukdoc74]

Only a med student is delusional to think Cardiology is more competitive than GI.

Ask any IM resident at a University program. Look at the Chief Residents at the top places and see what they do.

GI is more competitive than Cards.

 

[CanIMakeIt]

Out of curiosity, what type of salaries does cards start at now? I thought it paid quite well in the past, although I have heard that there were some cuts.

But you are absolutely right about the whole thing about hospitalist jobs being very popular these days. Where I did internship, most of the IM grads did go into hospitalist jobs. In the midwest where I'm at, it's not hard to find 300k hospitalist jobs. I get emails almost daily about needs, and the salaries are not bad, plus bonuses, some have flexible scheduling etc.

I guess you really have to think about doing an additional 3 years if you won't make that much more and are ok with being a hospitalist. Although initially the whole 26 weeks off might sound nice, I am not sure if I could work 7 days straight for 12 hours a day. That's brutal!

My understanding is ~$250K or so for genreal Cards with around $300K for interventional or EP but I am not a cardiologist - just what I heard.

 

[bronx43]

Only a med student is delusional to think Cardiology is more competitive than GI.

Ask any IM resident at a University program. Look at the Chief Residents at the top places and see what they do.

GI is more competitive than Cards.

I agree with this. Cardiology is just too diluted nowadays with the increase in fellowship spots. It is definitely as hard if not harder to get into top 10 cardiology as a top 10 GI program, but it's almost unheard of for an AMG from a university program not to match in cardiology but it happens far more often for GI.

As far as cards jobs and salaries go, the word on the street is that interventional jobs are tightening up a lot, and EP jobs are nearly non-existent. However, gen cards and heart failure can essentially go anywhere and get offers.

 

[josephf1]

i just got my first unofficial offer...
250
40 nights of call/year, 10 weekends/year, 4.5 days week work

all my hospitalist friends with some extra make over >300
they also have time to get pilot lisence, join book club, rent boats, ride motorcylces, etc

its funny people in my program still want to do EP???

 

[DrAwsome]

i just got my first unofficial offer...
250
40 nights of call/year, 10 weekends/year, 4.5 days week work

all my hospitalist friends with some extra make over >300
they also have time to get pilot lisence, join book club, rent boats, ride motorcylces, etc

its funny people in my program still want to do EP???

Over 300k for a hospitalist position? That seems a bit high even during these times of demand. Are you sure you got your info correct?

I think you kind of got hosed and some of your buddies may have gotten good offers. I have a friend who got a recent job for 420k in cards recently. Also remember that hospitalists work 91 hrs/week even if they get the next week off. That's pretty darn brutal, and it doesn't happen everywhere.

 

[bronx43]

i just got my first unofficial offer...
250
40 nights of call/year, 10 weekends/year, 4.5 days week work

all my hospitalist friends with some extra make over >300
they also have time to get pilot lisence, join book club, rent boats, ride motorcylces, etc

its funny people in my program still want to do EP???

Where is this cards offer located? And where are these 300k hospitalist jobs located?

 

[DrAwsome]

Where is this cards offer located? And where are these 300k hospitalist jobs located?

The 300K hospitalist positions are usually in places that are not big cities, a number of them are in TX, OK, central IN, Iowa, etc. Where I'm at, there are very few 300k hospitalist positions, most of them are in the 160-200k range and some even in the 140k.

That 250k cards offer seems tad low from what I've seen.

 

[badasshairday]

Over 300k for a hospitalist position? That seems a bit high even during these times of demand. Are you sure you got your info correct?

I think you kind of got hosed and some of your buddies may have gotten good offers. I have a friend who got a recent job for 420k in cards recently. Also remember that hospitalists work 91 hrs/week even if they get the next week off. That's pretty darn brutal, and it doesn't happen everywhere.

I'm doing my internship at a community hospital in a large city in the midwest (not Chicago) and the hospitalist make 300K for one week on and one week off. Every 4th day the attending for the teaching team will stay until 9pm, otherwise on other days they come in between 7:30-9:30am and leave between 4-7pm depending on patient load. So they probably work 70-80 hours per week. Just saying...

 

[DrAwsome]

I'm doing my internship at a community hospital in a large city in the midwest (not Chicago) and the hospitalist make 300K for one week on and one week off. Every 4th day the attending for the teaching team will stay until 9pm, otherwise on other days they come in between 7:30-9:30am and leave between 4-7pm depending on patient load. So they probably work 70-80 hours per week. Just saying...

Where I did my internship (also in midwest but not Chicago), the hospitalists made about 180k, + call. That's not bad though.

I still don't think it's typical, and I don't think it will last. And for every 300k hospitalist gig out there, there are many 160k + ones as well. Also, if they can't pay specialists 300k +, why would they pay PCPs that long term? I don't think it will last.

 

[bronx43]

Where I did my internship (also in midwest but not Chicago), the hospitalists made about 180k, + call. That's not bad though.

I still don't think it's typical, and I don't think it will last. And for every 300k hospitalist gig out there, there are many 160k + ones as well. Also, if they can't pay specialists 300k +, why would they pay PCPs that long term? I don't think it will last.

I would like to echo that hospitalists do not pull 300k where I am training (decent sized city in the Midwest). The recent numbers I've heard are around 200k base but it's for 18 days a month.

 

[DrAwsome]

I would like to echo that hospitalists do not pull 300k where I am training (decent sized city in the Midwest). The recent numbers I've heard are around 200k base but it's for 18 days a month.

For 18 day/mo hospitalists ? That's again not bad. I guess it is nice to have all that time off, but I'd rather have 6 + or so weeks vacation and work the rest of the days. I really hate working weekends.

 

[Eurostar]

City on the east coast academic teaching hospital hospitalists start at ~120-140k. No nights, every other week, but in your off week you are on backup call on some days in case something happens or it gets busy you need to come in. So its not really one week on and one week off.

That being said, general cards at the same hospital is starting ~220-250k. It all depends upon what you're looking for. Sure if you want to go to the rural midwest you can make good money no matter what job you do. BTW if you are choosing specialties based upon money thats concerning - I could have made a lot more money going to Wall St like most of my friends.

 

[DrVanNostran]

I'll throw in my 2 cents. I'm in Chicago right now and have friends who recently graduated.

Hospitalist: 160-180-->income potential low 200s
Mixed Practice: 150-170
Cards (general): 250ish-->income potential 350-400s
HemeOnc: 210-220ish-->income potential-->275-325

That was what was echoed by friends who recently were recruited. A majority of my friends left for smaller cities on the west coast with better pay.

 

[DrAwsome]

City on the east coast academic teaching hospital hospitalists start at ~120-140k. No nights, every other week, but in your off week you are on backup call on some days in case something happens or it gets busy you need to come in. So its not really one week on and one week off.

That being said, general cards at the same hospital is starting ~220-250k. It all depends upon what you're looking for. Sure if you want to go to the rural midwest you can make good money no matter what job you do. BTW if you are choosing specialties based upon money thats concerning - I could have made a lot more money going to Wall St like most of my friends.

You know the idea that everyone on Wall street is just raking it up is way way off. It's incredibly hard to get to the top where the big dogs make the big bucks. I have several people I know that have gone on to Wall Street and not only is the job security awful and nonexistent, but they work far more than most of us, and many of them do not make the money you think they do.

Also the idea that everyone in medicine would just strike it rich on Wall Street is also fundamentally wrong wrong wrong. The skills, personality, etc that's required on Wall Street is very different from what it takes to be a good doctor.

The grass is not always greener.

 

[DrVanNostran]

As for competitiveness of fields. I think it's pretty clear that GI>Cards>H/O these days with Pulm CC coming on strong. AMG at a decent IM program will pretty much get cards as long as they have a reputation of working hard and dedicated research. That same applicant in GI may not be so fortunate. H/O is pretty much a guarantee if you apply broadly. MDACC/MSKCC/Dana/Hopkins etc are probably as competitive as any fellowship in the country.

 

[DrVanNostran]

You know the idea that everyone on Wall street is just raking it up is way way off. It's incredibly hard to get to the top where the big dogs make the big bucks. I have several people I know that have gone on to Wall Street and not only is the job security awful and nonexistent, but they work far more than most of us, and many of them do not make the money you think they do.

Also the idea that everyone in medicine would just strike it rich on Wall Street is also fundamentally wrong wrong wrong. The skills, personality, etc that's required on Wall Street is very different from what it takes to be a good doctor.

The grass is not always greener.

Agreed. Wall Street is animal. My friends who are now in the business world are working their ***** off everyday always looking behind their shoulder. Not to mention, most of these guys are Ivy league caliber people. Physician salary is not as heavily based upon pedigree.

 

[Silent Cool]

Where is this cards offer located? And where are these 300k hospitalist jobs located?

Bronx,

Check out: www.physicianrecruiting.com

 

[DrAwsome]

Bronx,

Check out: www.physicianrecruiting.com

The pay for many of those jobs seems abysmally awful. I cannot say this enough, until someone realizes that 200k for a physician training over a decade is just not enough money, we will never get costs under control.

Consultants and marketing people make that within 5-8 years!! Quite depressing.

 

[bronx43]

The pay for many of those jobs seems abysmally awful. I cannot say this enough, until someone realizes that 200k for a physician training over a decade is just not enough money, we will never get costs under control.

Consultants and marketing people make that within 5-8 years!! Quite depressing.

I don't understand this statement. How would paying physicians more money get health care cost under control? I wouldn't be against more money in my pocket, but I don't see the logical train of thought.

 

[dragonfly99]

cards pays about 270k to start in my area (private type practice...academics is less)...this would be for general cards, with 2-3 weeks vacation a year, and taking call and probably doing invasive and/or you are an imaging specialist.
EP job market seems saturated (west coast).
General cards and interventional market seems OK. CHF is more an academic thing, or you can look for specialized things like running a CCU, etc.

 

[DrAwsome]

cards pays about 270k to start in my area (private type practice...academics is less)...this would be for general cards, with 2-3 weeks vacation a year, and taking call and probably doing invasive and/or you are an imaging specialist.
EP job market seems saturated (west coast).
General cards and interventional market seems OK. CHF is more an academic thing, or you can look for specialized things like running a CCU, etc.

Maybe I'm way off, but didn't cards use to pay a ton before? Or is that after a few years of practice? I've seen a number of ads for cardiologists in the 500k + range, and my understanding is that they made 600-700k a few years in. Has this changed or is this how this is now?

 

[DrAwsome]

I don't understand this statement. How would paying physicians more money get health care cost under control? I wouldn't be against more money in my pocket, but I don't see the logical train of thought.

Well let's see. Maybe if the salaries weren't so crappy, to the point that a nurse or other midlevel could make the same with 1/2 the training, maybe better people would go into primary care, less diseases would turn into catastrophies as they do now (ie-prevention of strokes, heart attacks, cancers, etc) which would save billions.

So we "save" by paying pennies at times to the people that should be making some decent money. That causes in my opinion, not the best and brightest to go into the field, they don't really care, less prevention, lack of time, etc.

It's all a disaster.

I make more money doing botox parties once per week than I would working as a hospitalist if I had done an IM/FM residency. It's pretty sad.

 

[ukdoc74]

Wait until the match results come out this year. If you talk to the heme/onc applicants this year was brutal. Only 400+ spots in heme/onc.

 

[ukdoc74]

As a comparison, if people know what general cardiologists and EP cardiologists to Heme/Onc. It is a no brainer. Heme/onc offers 6-8 weeks of vacation a year. No overnight emergencies compared to cardiology for the same amount of money.

Interventinal cards make more money but lifestyle is brutal.