Am I Under-/Overpaid?

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Hash Slinging Slasher

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Hey everyone,

Was hoping to get some insight about my salary and whether or not I should be content with it.

I graduated residency this year and accepted an academic psychiatry position straight out of residency at my state medical school in the Southeast along the Atlantic. The medical school partners with community / state organizations to deliver care which I help fulfill. My mornings are spent managing a cohort of about 8-10 inpatients myself at the state psychiatric hospital. In the afternoon depending on the weekday, I supervise 2 resident clinics (including a ketamine and outpatient clinic), teach medical students for a half-day, manage a cohort of 8-10 juvenile detention patients (half-day by myself), do ECT (8 patients / half-day myself), and or do TMS (myself doing motor mappings). If an inpatient colleague takes vacation, then in the mornings, I'll manage my cohort of inpatients AND also assume responsibility for their cohorts which can vary anywhere from 14-22 patients depending on how busy the state hospital is and then come to afternoon clinics with colleague's residents managing things on the inpatient side while I do my afternoon obligations. Same with other outpatient providers' resident clinics or ECT/TMS obligations.

I make 220K/yr (base). To supplement the income, I make an additional 70K/yr from internal moonlighting by working x2 12-hr shifts/month and x1 4hr afternoon shift every week. In-person call supervising residents at hospital once every 3 months but leave after patients are all seen. Out of everything I do, about 0.3 FTEs are considered "RVU-generating" with the rest of the obligations being "contract"/flat-fee contracts with community partners. So for me, if I earn a collected wRVU threshold valued above 66K in a year, then ~$58/wRVU is paid out as a non-pension-contributing bonus. I get about 20 CME days, a $5000 yearly CME stipend, and accrue sick and annual leave at 8 and 12hrs respectively so there's def other benefits that possibly make up for the lower salary.

The biggest draws to me accepting a state academic position was teaching, state benefits/pension (requires 10 years of employment to become vested), and sovereign immunity overring protection from malpractice. However, with state budget issues, I'm not likely to get a raise next year (meaning I'll be making less after inflation), and the work has been keeping me very busy. Obvs, comparison is the thief of joy but wage but so is working under the value of what you bring. I'm seeing some of my former co-residents working in academics are making >275-300K in other parts of the country and I'm wondering if I hastily accepted too low of a salary or if I should be content where I'm at.

Question: Is my base salary reasonable / fair for what I do?

Would welcome any thoughts you all had
 
Question: Is my base salary reasonable / fair for what I do?
Do you feel fairly compensated for the work you do? I think that's all that ultimately matters regardless of the actual salary. If your answer is "no" then it's just a matter of time until resentment and/or burnout sets in. I didn't feel fairly compensated for my work until I crossed the $600k mark.
 
All told how many hours a week are you at work on average?
In addition to this, how many patient encounters per day?

I’m Midwest academic making 260k-280k/yr seeing 8-10 patients most days with call q7-8 weekends on what’s basically a 3 week on/1 week off schedule. What OP is describing sounds like low pay for the amount of work, but that’s academia…

One thing I find a bit crazy is that it’s 10 years to full vestment in benefits. I hope that’s 10 years to obtain the full pension with other retirement accounts fully vested before that, which isn’t horrible if that’s the state plan. Otherwise yikes to those golden handcuffs. Im fully vested at 5 years and I don’t love waiting that long.
 
20 CME days? A paid month off for CME every year? That is a huge benefit. Overall the pay seems fine, particularly for the South.. Personally, I don't like it when inpatient and outpatient are split like you have it some days, but I guess other people do. I think you make it all too complicated with RVUs, number of patients and call, etc. Just add up the total salary and benefits and the hours you work per week (accounting for all that leave.)
 
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20 CME days? A paid month off for CME every year? That is a huge benefit. Overall the pay seems fine, particularly for the South.. Personally, I don't like it when inpatient and outpatient are split like you have it some days, but I guess other people do. I think you make it all too complicated with RVUs, number of patients and call, etc. Just add up the total salary and benefits and the hours you work per week (accounting for all that leave.)
Yes with expenses up to $5000/yr. After accounting for registration, airfare, hotels, etc it seems like it would cover about 1.5 conferences but not much beyond. If I foot the bill afterwards, then yes, I can still use the time to do CMEs

Not sure if that's standard or unusual in academia, but I'd love to hear your thoughts
 
In addition to this, how many patient encounters per day?

I’m Midwest academic making 260k-280k/yr seeing 8-10 patients most days with call q7-8 weekends on what’s basically a 3 week on/1 week off schedule. What OP is describing sounds like low pay for the amount of work, but that’s academia…

One thing I find a bit crazy is that it’s 10 years to full vestment in benefits. I hope that’s 10 years to obtain the full pension with other retirement accounts fully vested before that, which isn’t horrible if that’s the state plan. Otherwise yikes to those golden handcuffs. Im fully vested at 5 years and I don’t love waiting that long.
Yes, it's 10 years to become vested/eligible for the pension. You also have to be 60+ in age before it pays out (or earlier with penalty if still 10+ years of service)
 
Do you feel fairly compensated for the work you do? I think that's all that ultimately matters regardless of the actual salary. If your answer is "no" then it's just a matter of time until resentment and/or burnout sets in. I didn't feel fairly compensated for my work until I crossed the $600k mark.
I guess that was one of the reasons for me coming here to ask hahaha

I don't really know if my salary is truly "fair" since I can't compare to other places as I'm sticking around at the same place I trained

I like what I do for sure. But if my salary/work was low-balled, then I don't want to feel like a sucker whose new grad naivety got taken advantage of. I also don't want to be an ingrate either, because if I've got a good thing going, I'll roll with the punches and be grateful for what I have

I guess I'm asking based on your all's collective experiences, what would you feel about my current salary/work situation...
 
I guess that was one of the reasons for me coming here to ask hahaha

I don't really know if my salary is truly "fair" since I can't compare to other places as I'm sticking around at the same place I trained

I like what I do for sure. But if my salary/work was low-balled, then I don't want to feel like a sucker whose new grad naivety got taken advantage of. I also don't want to be an ingrate either, because if I've got a good thing going, I'll roll with the punches and be grateful for what I have

I guess I'm asking based on your all's collective experiences, what would you feel about my current salary/work situation...

$290k for 50hrs/week is underpaid, however you're in academia so being underpaid comes with the territory. I'm sure academia has it's perks, but financial fairness is not typically one of them. You're doing inpatient, outpatient, ketamine, TMS, ECT, resident supervision, and two 12hr weekend shifts per month? I would demand $1MM/year for the workload you described, but I guess that's why I'm not in academia.
 
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