Academic Internal Medicine - salary?

[nope80]

Hi,

So we all know that when you go into academic IM you take a significant pay cut. I'm wondering though, how does ones salary change over time? What are the ranges for academic IM if you are part time outpatient and part time inpatient or all inpatient, for example. Also, if one gets involved with program leadership who does that change your salary. I have always wondered what our associate PDs or PD make? Anyway, have any idea?

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[IMPD]

Hi,

So we all know that when you go into academic IM you take a significant pay cut. I'm wondering though, how does ones salary change over time? What are the ranges for academic IM if you are part time outpatient and part time inpatient or all inpatient, for example. Also, if one gets involved with program leadership who does that change your salary. I have always wondered what our associate PDs or PD make? Anyway, have any idea?

Unlike many skilled positions, academic medicine has not clearcut pay scale, mainly because people who end up getting involved as APD PD or DIO (Designated Institutional Officer), usually have other institutional appointments and jobs. Thus, a school's DIO might also be a Senior Dean for Blah Blah Blah. A PD might also be the DIO. An APD might be the Division Chief for Pulmonary. So, since these jobs are all "part time", they don't have distinct paylines. My professional organization takes a poll couple of years on people's salary (because we're all curious what the other PDs are being paid). The poll isn't that helpful in the end, because of the factors I cited above.

In general, there is a good deal of money paid to administer education, but the work is all part-time and combined with other leadership gigs usually. The ladder up for ambitious PDs includes moving into the Dean's office to become Senior Dean of this-or-that.

 

[nope80]

Thats really interesting. But so on average, what are the ranges? I'm just curious since I have no basis one way or another.

 

[IMPD]

Thats really interesting. But so on average, what are the ranges? I'm just curious since I have no basis one way or another.

I recently heard of a PD job in the South offering 250k. Probably more like 180 in NE. Extremely dependent on the other "jobs"/seniority/academic rank that the person has. Only the largest programs have "full time" PDs.

The pay for academic rank could be another entire book. Publish, serve on committees, make friends and move up in rank. Pay moves up too.

 

[flipmd]

Depends what kind of "academic IM" you want. Hospitalists who do both hospitalist work and housestaff attending alternating are paid the same as staff at the area non-teaching hospitals where I trained at (except the community places allowed you to work more to get paid more). Also, outpatient pure clinician academic positions paid the same as similar non-teaching positions in the county system where I trained. The people who really lost out were those who wanted research, who seemed to tend to get paid much less.

 

[VentdependenT]

Hi,

So we all know that when you go into academic IM you take a significant pay cut. I'm wondering though, how does ones salary change over time? What are the ranges for academic IM if you are part time outpatient and part time inpatient or all inpatient, for example. Also, if one gets involved with program leadership who does that change your salary. I have always wondered what our associate PDs or PD make? Anyway, have any idea?

probably 120k for academic hospitalist

 

[MedicineDoc]

A hospital where I was working with IM residents as part of their away hospitalist rural rotation was same as regular old permanent hospitalist. I think they made me an initial offer of something like 220K. I ca't see anyone taking a job for 120 K as an MD in any specialty. My FM attendings in residency were making 300 K. They did in and outpatient and alternated days with other attendings with teaching/supervising residents both hospital/outpatient and seeing their own private patients in addition to FM resident clinic outpt and inpt and unassigned inpts including ICU. Yes they worked a lot.

 

[flipmd]

probably 120k for academic hospitalist

Unless there's a significant research component / time, I don't think that's right. At least in where I did my residency, and in 3 places I looked at (Pacific NW, West coast big city, West coast smaller city), hospitalists that did half of their weeks attending on resident teams and half alone in the hospitalist service were paid competitively for the area - 200+ base plus RVU-based bonuses. This is in addition to the usual week-on/off schedule. These places were "top 20" IM places and one that was "mid tier" based on what passes for consensus here on SDN.

 

[VentdependenT]

Unless there's a significant research component / time, I don't think that's right. At least in where I did my residency, and in 3 places I looked at (Pacific NW, West coast big city, West coast smaller city), hospitalists that did half of their weeks attending on resident teams and half alone in the hospitalist service were paid competitively for the area - 200+ base plus RVU-based bonuses. This is in addition to the usual week-on/off schedule. These places were "top 20" IM places and one that was "mid tier" based on what passes for consensus here on SDN.

There is no way that an academic medicine attending makes e same amount as a private practice hospitalist, which is what you are suggesting. Mot unless they are doing something on the side, which these guys are. That is not a typical academic hospitalist job...

 

[VentdependenT]

A hospital where I was working with IM residents as part of their away hospitalist rural rotation was same as regular old permanent hospitalist. I think they made me an initial offer of something like 220K. I ca't see anyone taking a job for 120 K as an MD in any specialty. My FM attendings in residency were making 300 K. They did in and outpatient and alternated days with other attendings with teaching/supervising residents both hospital/outpatient and seeing their own private patients in addition to FM resident clinic outpt and inpt and unassigned inpts including ICU. Yes they worked a lot.

Thats not a academic hospitalist job. Sounda like those medicine attendings are inPP and are being kind to a medicine residency

 

[jdh71]

There is no way that an academic medicine attending makes e same amount as a private practice hospitalist, which is what you are suggesting. Mot unless they are doing something on the side, which these guys are. That is not a typical academic hospitalist job...

Not at a real university gig anyway.

Plenty of community shops, ostensibly with with a residency program, where you can be in "academics".

If you are not doing research, then you are not really in "academics" even if you work as a clinical instructor.

Though, it wouldn't surprise me if there has been some salary creep on the university side of IM for clinical instructors, or how else are they going to get enough people to stay and do it? The lowest form of life in the hospital hierarchy anywhere in academics is the general internal medicine service.

 

[flipmd]

There is no way that an academic medicine attending makes e same amount as a private practice hospitalist, which is what you are suggesting. Mot unless they are doing something on the side, which these guys are. That is not a typical academic hospitalist job...

These are University programs that are "top 20" to "top 30". You work as the attending on a resident team on half of your weeks, then be on the hospitalist service on the other half. Like I mentioned earlier, it depends on what kind of "academic" career you want. These academic hospitalists do QI and may or may not be involved in the program as administrators (personal preference if you want to), but no real hard core research. The researchers cut into clinical time, and are paid much less. These are not Hopkins or UCSF or any "top 5" place.

Private practice job offers in the same area were in the same ballpark. If you guys have other experiences, I'd like to hear it but these are offers made to me and are based on my own experiences. Your own experiences may differ.

 

[flipmd]

probably 120k for academic hospitalist

No MD should take 120K (especially if there's a "probably" attached to it) unless you're doing research at least half the time and they give you your own lab.

 

[nope80]

Why is that if you are doing research you would take such a pay cut?? What is the incentive for anyone to do research if they are going to be making hardly anything. I mean obviously you have to be interested but it doesn't make sense to take such an enormous paycut. Is that truly the case, what was cited above?

 

[gutonc]

Why is that if you are doing research you would take such a pay cut?? What is the incentive for anyone to do research if they are going to be making hardly anything. I mean obviously you have to be interested but it doesn't make sense to take such an enormous paycut. Is that truly the case, what was cited above?

Because they want to do the research. Not everyone is in it for the money. But I anticipate a massive sea change over the next 3-10 years.

As a concrete example, I took a 60(R)/40(C) position for the last year trying to launch my (essentially stillborn) research career. I made $120K virtually all off my clinical time. After failing miserably (and having 3 more grants rejected), I said, F**k It, picked up one more clinical day, only work 3 days a week and make more than a newly minted academic attending at the same institution.

The days of slush funds for academic work are over. My institution (not division, not department, but the whole damn campus...the largest employer in the state) recently got rid of all reimbursement for "teaching time". You need to make up your salary with RVUs or grants. Period. It's the wave of the future.

 

[nope80]

hmm so if you had the grant, would you have been able to pay yourself with your grant money to supplement your income?

 

[gutonc]

hmm so if you had the grant, would you have been able to pay yourself with your grant money to supplement your income?

Theoretically. But you also want to have funds to do the work. I worked with/for a (PhD only...the rules are a little different) PI who has foregone 10 years of salary increases in order to put more money back into the lab. There's a PI/PD in the MD/PhD forum who flips his clinical RVU-based bonus back into the lab to help pay grad student salaries. That's great (that he's willing to do it) but sucks (that he has to).

But when i realized that, if everything went perfectly (which, of course, it wouldn't), in 3-4 years I might be able to pay myself to do research, I bowed my head and walked away. I was sad to leave the lab but happy to have something to "fall back on".

 

[nope80]

But if you are doing clinical research not involving a lab with tons of expenses, maybe it could work...? This is really discouraging though, since I really love research but it sounds like there are some major hurdles....

 

[michaelrack]

But if you are doing clinical research not involving a lab with tons of expenses, maybe it could work...? This is really discouraging though, since I really love research but it sounds like there are some major hurdles....

If you are doing the type of clinical research that you get a grant for, there will also be a ton of expenses.

 

[nope80]

wow this is so discouraging.

 

[gutonc]

If you are doing the type of clinical research that you get a grant for, there will also be a ton of expenses.

^This

wow this is so discouraging.

Welcome to the real world pumpkin.

 

[jdh71]

Theoretically. But you also want to have funds to do the work. I worked with/for a (PhD only...the rules are a little different) PI who has foregone 10 years of salary increases in order to put more money back into the lab. There's a PI/PD in the MD/PhD forum who flips his clinical RVU-based bonus back into the lab to help pay grad student salaries. That's great (that he's willing to do it) but sucks (that he has to).

But when i realized that, if everything went perfectly (which, of course, it wouldn't), in 3-4 years I might be able to pay myself to do research, I bowed my head and walked away. I was sad to leave the lab but happy to have something to "fall back on".

After reading this I no longer feel too bad at all about my decision to leave academics. It's made me a bit of persona non grata with one or two people, but most people seem to understand. I'm not slaving for 8-10 years only to hope that I land some funding. Plus. I don't know how some of these guys can say they like putting together a grant. I'd probably rather do horrible sexual favors than ever attempt another grant.

I'm finishing my current paper and data collect as much for the "next paper" as I can help with and then I'm OUT. June 30 will be the last day in a lab ever.

Gunna go move some meat and hand out inhalers. And get paid well to do it half the year. Done.

 

[dragonfly99]

This is really sad. I had aspirations of doing clinical research at one point as well.
I don't know what we are going to do for "medical innovation" in a few years, if this continues.
On a similar note, I know several PhD people who have done a couple of post docs, with good publications, and who are smart, good personalities, etc. and still having trouble finding a permanent job. They get stuck in some sort of post post doc ghetto where they are in someone's lab as a researcher, at essentially a post doc salary, that they might lose on short notice of the PI of the lab doesn't get his/her latest grant.

 

[nope80]

Any thoughts on how hard it is to get a job in a top academic center for academic hospitalist right out of residency? Are these spots hard to come by? What do they look for when hiring?

Also, what are the ranges in salary for academic hospitalist at a top place (assuming no research, just clinical)?

 

[AlmostAnMD]

Any thoughts on how hard it is to get a job in a top academic center for academic hospitalist right out of residency? Are these spots hard to come by? What do they look for when hiring?

Also, what are the ranges in salary for academic hospitalist at a top place (assuming no research, just clinical)?

Also, If it's just clinical and no research, are you getting only a clinical assistant professorship? ie, no tenure? I think that's how it works, maybe someone here can explain that...sorry to piggyback on your question.

 

[nope80]

Also, If it's just clinical and no research, are you getting only a clinical assistant professorship? ie, no tenure? I think that's how it works, maybe someone here can explain that...sorry to piggyback on your question.

No problem, I think a lot of us are wondering about this topic. And also, as a third question, what is the added benefit of a GIM fellowship? Seems somewhat redundant to me after IM residency...

 

[flipmd]

Also, If it's just clinical and no research, are you getting only a clinical assistant professorship? ie, no tenure? I think that's how it works, maybe someone here can explain that...sorry to piggyback on your question.

I would PM ZdoggMD for this.

But like I said, some of the offers I was getting for purely clinical in top 20 places was 200+ with additional RVU bonuses

You get anything from clinical instructor to asst professor, depending on the place.

 

[nope80]

I would PM ZdoggMD for this.

But like I said, some of the offers I was getting for purely clinical in top 20 places was 200+ with additional RVU bonuses

You get anything from clinical instructor to asst professor, depending on the place.

Thanks flipmd🙂 Are you currently working as a hospitalist? In your experience, and obviously i'm sure it depends on the location, but was it relatively easy to get offers from top 20 places and if so, was there certain things they were looking for in applicants. Also, what was the schedule like at these academic places - since i'm assuming its not the 7 on 7 off structure we are used to hearing about.

 

[CaptainSSO]

The lowest form of life in the hospital hierarchy anywhere in academics is the general internal medicine service.

And why is that?

 

[dragonfly99]

Because they are everyone's b*tch and most academic specialists are pretty snobby in the sense that they think they are smarter than general IM people.
It does depend somewhat on the culture of the place that you work, though.
In the private world, if we are not relatively "nice" to the hospitalists and outpatient primary care docs and ER docs, they may not call us to do consults so then we won't get enough business.

 

[slippy22]

Because they are everyone's b*tch and most academic specialists are pretty snobby in the sense that they think they are smarter than general IM people.
It does depend somewhat on the culture of the place that you work, though.
In the private world, if we are not relatively "nice" to the hospitalists and outpatient primary care docs and ER docs, they may not call us to do consults so then we won't get enough business.

Yes, why is that? To me it always seemed a lot easier to be a consultant who answers one specific question than the primary team, which has to integrate the many recommendations (often contradictory, as they focus just on the consultant's specific organ system without any regard for the patient as a whole) and come up with a coherent plan. I guess that's just the crazy nature of our healthcare system. Subspecialists who just have to address a specific question feel superior to the generalists who actually have to think about the patient. Sigh.